I-acute nephritic syndrome

I-acute nephritic syndrome iyiqembu lezimpawu ezenzeka ngezifo ezithile ezibangela ukuvuvukala nokuvuvukala kwe-glomeruli ezinso, noma i-glomerulonephritis.

I-acute nephritic syndrome ivame ukubangelwa ukuphendula komzimba okubangelwa ukutheleleka noma esinye isifo.

Izimbangela ezivamile ezinganeni nasebusheni zifaka:

• I-hemolytic uremic syndrome (ukuphazamiseka okwenzeka lapho ukutheleleka ohlelweni lokugaya ukudla kukhiqiza izinto ezinobuthi ezonakalisa amangqamuzana abomvu egazi futhi zidale ukulimala kwezinso)
• I-Henoch-Schönlein purpura (isifo esifaka amabala ansomi esikhunjeni, ubuhlungu bamalunga, izinkinga zamathumbu kanye ne-glomerulonephritis)
• I-IgA nephropathy (ukuphazamiseka lapho amasosha omzimba abizwa nge-IgA akha ezicutshini zezinso)
• I-post-streptococcal glomerulonephritis (ukuphazamiseka kwezinso okwenzeka ngemuva kokutheleleka ngezinhlobo ezithile zamagciwane e-streptococcus)

Izimbangela ezivamile kubantu abadala zifaka:

• Amathumba esiswini
• I-Goodpasture syndrome (ukuphazamiseka lapho amasosha omzimba ahlasela khona i-glomeruli)
• IHepatitis B noma C
• I-Endocarditis (ukuvuvukala kolwelwesi lwangaphakathi lwamagumbi enhliziyo namavalvu enhliziyo abangelwa ukutheleleka ngegciwane noma ukhunta)
• I-Membranoproliferative glomerulonephritis (ukuphazamiseka okubandakanya ukuvuvukala nezinguquko kumaseli ezinso)
• I-glomerulonephritis eqhubeka ngokushesha (i-crescentic) (uhlobo lwe-glomerulonephritis eholela ekulahlekelweni okusheshayo kokusebenza kwezinso)
• I-Lupus nephritis (inkinga yezinso ye-systemic lupus erythematosus)
• I-Vasculitis (ukuvuvukala kwemithambo yegazi)
• Izifo ezibangelwa amagciwane ezifana ne-mononucleosis, isimungumungwane, omunyu

Ukuvuvukala kuthinta ukusebenza kwe-glomerulus. Le yingxenye yesinso ehlunga igazi ukuze yenze umchamo futhi isuse imfucuza. Ngenxa yalokhu, kuvela igazi namaprotheni emchameni, bese kukhuphuka uketshezi oluningi emzimbeni.

Ukuvuvukala komzimba kwenzeka lapho igazi lilahlekelwa yiprotheni ebizwa nge-albumin. I-albhamuin igcina uketshezi emithanjeni yegazi. Lapho ilahlekile, uketshezi luqoqa ezicutshini zomzimba.

Ukwehla kwegazi ezakhiweni zezinso ezilimele kuholela egazini emchameni.

Izimpawu ezivamile ze-nephritic syndrome yilezi:

• Igazi emchameni (umchamo ubonakala umnyama, unombala wetiye, noma unamafu)
• Ukwehla kokukhishwa komchamo (kungakhishwa umchamo omncane noma cha)
• Ukuvuvukala kobuso, isokhethi yamehlo, imilenze, izingalo, izandla, izinyawo, isisu, noma ezinye izindawo
• Umfutho wegazi ophezulu

Ezinye izimpawu ezingenzeka zibandakanya:

• Ukubona okufiphele, imvamisa kusuka emithanjeni yegazi eqhume ku-retina yeso
• Ukukhwehlela okuqukethe amafinyila noma okubomvana, okubunjiwe okuvela kuketshezi lwamaphaphu
• Ukuphefumula okuncane, kusuka ekwakhiweni koketshezi emaphashini
• Ukugula (ukugula) okujwayelekile, ukozela, ukudideka, izinhlungu nezinhlungu, ikhanda elibuhlungu

Izimpawu zokwehluleka okukhulu kwezinso noma zesifo sesikhathi eside (esingapheli) sezinso zingakhula.

Ngesikhathi sokuhlolwa, umhlinzeki wakho wezokunakekelwa kwempilo angathola izimpawu ezilandelayo:

• Umfutho wegazi ophezulu
• Inhliziyo engajwayelekile kanye namaphaphu kuzwakala
• Izimpawu zoketshezi oluningi (i-edema) njengokuvuvukala emilenzeni, ezingalweni, ebusweni nasesiswini
• Isibindi esandisiwe
• Imithambo ekhulisiwe entanyeni

Ukuhlolwa okungenziwa kufaka phakathi:

• Ama-electrolyte egazi
• Igazi urea nitrogen (BUN)
• I-Creatinine
• Imvume ye-Creatinine
• Ukuhlolwa kwe-potassium
• Amaprotheni emchameni
• Ukuhlolwa komchamo

I-biopsy yezinso izokhombisa ukuvuvukala kwe-glomeruli, okungakhombisa imbangela yalesi simo.

Ukuhlolwa kokuthola imbangela ye-acute nephritic syndrome kungafaka:

• Isihloko se-ANA se-lupus
• Ama-antibody e-antigenlomerular engaphansi
• Antineutrophil cytoplasmic antibody ye-vasculitis (ANCA)
• Isiko legazi
• Isiko lomphimbo noma lesikhumba
• Umsizi weSerum (C3 no-C4)

Inhloso yokwelashwa ukunciphisa ukuvuvukala ezinso nokulawula umfutho wegazi ophakeme. Ungadinga ukuthi uhlale esibhedlela ukuze uthole ukuthi welashwa.

Umhlinzeki wakho angancoma:

• Bedrest uze uzizwe ungcono ngokwelashwa
• Ukudla okunqanda usawoti, uketshezi, ne-potassium
• Imithi yokulawula umfutho wegazi ophezulu, ukunciphisa ukuvuvukala, noma ukususa uketshezi emzimbeni wakho
• I-dialysis yezinso, uma kudingeka

Umbono uncike kwisifo esidala i-nephritis. Lapho isimo sithuthuka, izimpawu zokugcinwa koketshezi (njengokuvuvukala nokukhwehlela) kanye nomfutho wegazi ophakeme kungaphela kumaviki awu-1 noma ama-2. Ukuhlolwa komchamo kungathatha izinyanga ukubuyela kokujwayelekile.

Izingane zivame ukwenza kangcono kunabantu abadala futhi zivame ukululama ngokuphelele. Kukancane kuphela lapho eba nezinkinga noma athuthuke aye kwi-glomerulonephritis engapheli nesifo esingapheliyo sezinso.

Abantu abadala abalulami kahle noma ngokushesha njengezingane. Yize kungavamile ukuthi lesi sifo sibuye, kwabanye abantu abadala, lesi sifo siyabuya futhi bayoba nesifo sezinso sokugcina futhi singadinga i-dialysis noma ukufakelwa izinso.

Shayela umhlinzeki wakho uma unezimpawu ze-acute nephritic syndrome.

Imvamisa, lesi sifo asikwazi ukuvinjelwa, noma ukwelashwa kokugula nokutheleleka kungasiza ekwehliseni ubungozi.

I-Glomerulonephritis - ebukhali; I-glomerulonephritis enamandla; I-Nephritis syndrome - ebukhali

• Ukwakheka kwezinso
• I-Glomerulus nephron

URadhakrishnan J, i-Appel GB. Ukuphazamiseka kwe-Glomerular kanye nama-syndromes we-nephrotic. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 113.

USaha M, uPendergraft WF, uJennette JC, uFalk RJ. Isifo esiyisisekelo se-glomerular. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ama-eds. IBrenner neRector's The Kidney. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 31.