I-distalalicular tubular acidosis

I-distal renal tubular acidosis yisifo esenzeka lapho izinso zingasusi kahle ama-asidi egazini ziye emchameni. Ngenxa yalokho, i-asidi eningi isala egazini (elibizwa nge-acidosis).

Lapho umzimba wenza imisebenzi yawo ejwayelekile, ukhiqiza i-asidi. Uma le asidi ingasuswa noma inciphiswe, igazi liba ne-esidi kakhulu. Lokhu kungaholela ekungalingani kwe-electrolyte egazini. Kungadala nezinkinga ngokusebenza okujwayelekile kwamanye amaseli.

Izinso zisiza ukulawula izinga le-asidi yomzimba ngokususa i-asidi egazini nokuyikhiphela emchameni.

I-distal renal tubular acidosis (uhlobo I-RTA) ibangelwa ukukhubazeka kumashubhu ezinso okwenza i-asidi yakhe egazini.

Uhlobo I-RTA lubangelwa izimo ezahlukahlukene, kufaka phakathi:

• I-Amyloidosis, inqwaba yamaprotheni angajwayelekile, abizwa ngama-amyloid, ezicutshini nasezitho zomzimba
• Isifo se-Fabry, isakhiwo esingajwayelekile emzimbeni wohlobo oluthile lwento enamafutha
• Izinga eliphakeme le-calcium egazini
• Isifo se-Sickle cell, amangqamuzana abomvu egazi ajwayele ukwakheka njenge-disk athatha isikela noma ukwakheka
• I-Sjögren syndrome, isifo se-autoimmune lapho izindlala ezikhiqiza izinyembezi namathe zibhujiswa khona
• ISystemic lupus erythematosus, isifo esizimele lapho amasosha omzimba ahlasela ngephutha izicubu ezinempilo
• Isifo i-Wilson, ukuphazamiseka okuzuzwe njengefa lapho kunethusi eliningi kakhulu ezicutshini zomzimba
• Ukusetshenziswa kwemithi ethile, njenge-amphotericin B, i-lithium, ne-analgesics

Izimpawu ze-distal renal tubular acidosis zifaka noma yikuphi okulandelayo:

• Ukudideka noma ukwehla kokuqwashisa
• Ukukhathala
• Ukukhula okungakhubazekile ezinganeni
• Izinga lokuphefumula lenyuke
• Amatshe ezinso
• I-Nephrocalcinosis (i-calcium eningi efakwe ezinso)
• I-Osteomalacia (ukuthambisa amathambo)
• Ubuthakathaka bemisipha

Ezinye izimpawu zingafaka:

• Ubuhlungu bamathambo
• Ukwehla kokukhishwa komchamo
• Ukunyuka kwenhliziyo noma ukushaya kwenhliziyo okungajwayelekile
• Amajaqamba emisipha
• Ubuhlungu ngemuva, ohlangothini, noma esiswini
• Ukukhubazeka kwamathambo

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Izivivinyo ezinga-odwa zifaka:

• Igazi legazi lomzimba
• Amakhemikhali egazi
• Umchamo pH
• Ukuhlolwa komthwalo we-acid
• Ukuhlolwa kokufakwa kwe-bicarbonate
• Ukuhlolwa komchamo

Ukufakwa kwe-calcium ezinso nasezinsweni zezinso kungabonakala ku:

• Ama-X-ray
• I-Ultrasound
• Iskena se-CT

Umgomo ukubuyisela izinga le-asidi ejwayelekile kanye nebhalansi ye-electrolyte emzimbeni. Lokhu kuzosiza ukulungisa ukuphazamiseka kwethambo futhi kunciphise ukwakhiwa kwe-calcium ezinso (nephrocalcinosis) namatshe ezinso.

Imbangela eyisisekelo ye-distal renal tubular acidosis kufanele ilungiswe uma ingabonakala.

Imithi engabekwa ifaka i-potassium citrate, i-sodium bicarbonate, ne-thiazide diuretics. Le yimithi ene-alkaline esiza ukulungisa isimo se-asidi yomzimba. I-sodium bicarbonate ingalungisa ukulahleka kwe-potassium ne-calcium.

Lesi sifo kufanele silashwe ukunciphisa imiphumela yaso kanye nezinkinga, ezingaba unomphela noma zisongele impilo. Izimo eziningi ziba ngcono ngokwelashwa.

Shayela umhlinzeki wakho uma unezimpawu ze-distal renal tubular acidosis.

Thola usizo lwezokwelapha ngokushesha uma uba nezimpawu zesimo esiphuthumayo njenge:

• Ukwehla kokuqonda
• Ukuquleka
• Ukwehla okukhulu kokuqapha noma kokuma

Akukho ukuvinjelwa kwalesi sifo.

I-renal tubular acidosis - i-distal; Uhlobo lwe-renal tubular acidosis I; Thayipha I-RTA; RTA - distal; I-Classical RTA

• Ukwakheka kwezinso
• Izinso - ukugeleza kwegazi nomchamo

UBushinsky DA. Amatshe ezinso. Ku: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 32.

I-Dixon BP. I-acidosis tubular yezinso. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 547.

Seifter JL. Izinkinga ze-acid-base. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 110.