Isifo sezinso sokugcina

Isifo sezinso sokugcina (ESKD) yisigaba sokugcina sesifo sezinso sesikhathi eside (esingapheli). Yilapho izinso zakho zingasakwazi ukuxhasa izidingo zomzimba wakho.

Isifo sezinso se-end-stage sibizwa nangokuthi isifo se-end-stage renal (ESRD).

Izinso zisusa imfucuza namanzi amaningi emzimbeni. I-ESRD yenzeka lapho izinso zingasakwazi ukusebenza ezingeni elidingekayo empilweni yansuku zonke.

Izimbangela ezivame kakhulu ze-ESRD e-United States yisifo sikashukela nomfutho wegazi ophezulu. Lezi zimo zingathinta izinso zakho.

I-ESRD cishe njalo iza ngemuva kwesifo esingapheliyo sezinso. Izinso zingayeka kancane ukusebenza ngesikhathi esiyiminyaka eyishumi kuya kwengu-20 ngaphambi kwemiphumela yesifo sokuphela.

Izimpawu ezivamile zingafaka:

• Ukugula okujwayelekile nokukhathala
• Ukulunywa (pruritus) nesikhumba esomile
• Ubuhlungu bekhanda
• Ukwehla kwesisindo ngaphandle kokuzama
• Ukuphelelwa isifiso sokudla
• Isicanucanu

Ezinye izimpawu zingafaka:

• Isikhumba esimnyama ngokungajwayelekile noma esikhanyayo
• Izinguquko zesipikili
• Ubuhlungu bamathambo
• Ukozela nokudideka
• Izinkinga ukugxila noma ukucabanga
• Ubuntofontofo ezandleni, ezinyaweni, noma kwezinye izindawo
• Ukudikiza kwemisipha noma amajaqamba
• Iphunga lokuphefumula
• Ukulimala okulula, ukuphuma kwamakhala, noma igazi esitokisini
• Ukoma ngokweqile
• Ama-hiccups avamile
• Izinkinga ngomsebenzi wezocansi
• Isikhathi sokuya esikhathini siyayeka (amenorrhea)
• Izinkinga zokulala
• Ukuvuvukala kwezinyawo nezandla (i-edema)
• Ukuhlanza, imvamisa ekuseni

Umhlinzeki wakho wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba noku-oda ukuhlolwa kwegazi. Iningi labantu abanalesi simo linomfutho wegazi ophezulu.

Abantu abane-ESRD bazokwenza umchamo omncane kakhulu, noma izinso zabo ngeke zisenza umchamo.

I-ESRD ishintsha imiphumela yezivivinyo eziningi. Abantu abathola i-dialysis bazodinga ukuthi lezi nezinye izivivinyo zenziwe kaningi:

• I-potassium
• Sodium
• I-albhamuin
• I-Phosphorus
• I-calcium
• Cholesterol
• Magnesium
• Qedela ukubalwa kwegazi (CBC)
• Ama-electrolyte

Lesi sifo singashintsha nemiphumela yokuhlolwa okulandelayo:

• Uvithamini D
• I-hormone ye-Parathyroid
• Ukuhlolwa kwesisindo samathambo

I-ESRD ingadinga ukuphathwa nge-dialysis noma ukufakelwa kwezinso. Ungadinga ukuhlala ekudleni okukhethekile noma uthathe imithi yokusiza umzimba wakho usebenze kahle.

I-DIALYSIS

I-Dialysis yenza omunye umsebenzi wezinso lapho ziyeka ukusebenza kahle.

I-Dialysis ingakwazi:

• Susa usawoti owengeziwe, amanzi nemikhiqizo kadoti ukuze kungakhi emzimbeni wakho
• Gcina amazinga aphephile amaminerali namavithamini emzimbeni wakho
• Siza ukulawula umfutho wegazi
• Siza umzimba wenze amangqamuzana abomvu egazi

Umhlinzeki wakho uzoxoxa nawe nge-dialysis ngaphambi kokuthi uyidinge. I-Dialysis isusa imfucuza egazini lakho lapho izinso zakho zingasakwazi ukwenza umsebenzi wazo.

• Imvamisa, uzoya ku-dialysis uma ususele ku-10% kuya ku-15% womsebenzi wakho wezinso.
• Ngisho nabantu abalinde ukufakelwa izinso bangadinga i-dialysis ngenkathi belindile.

Izindlela ezimbili ezihlukene zisetshenziselwa ukwenza i-dialysis:

• Ngesikhathi se-hemodialysis, igazi lakho lidlula ngepayipi lingene ezinso, noma isihlungi. Le ndlela ingenziwa ekhaya noma esikhungweni se-dialysis.
• Ngesikhathi se-peritoneal dialysis, isixazululo esikhethekile sidlula esiswini sakho yize kuyipayipi le-catheter. Isixazululo sihlala esiswini sakho isikhathi esithile bese siyasuswa. Le ndlela ingenziwa ekhaya, emsebenzini, noma ngenkathi usohambweni.

UKUTSHALALA KWEZINYO

Ukufakelwa kwezinso ukuhlinzwa ukubeka izinso ezinempilo kumuntu onenkinga yokuhluleka kwezinso. Udokotela wakho uzokuthumela esikhungweni sokufakelwa kabusha. Lapho, uzobonwa futhi uhlolwe yithimba lokufakelwa kabusha. Bazofuna ukuqinisekisa ukuthi ungumuntu olungele ukhetho lokufakelwa izinso.

UKUDLA OKUKHETHEKILE

Ungadinga ukuqhubeka nokulandela ukudla okhethekile kwesifo esingapheliyo sezinso. Ukudla kungafaka:

• Ukudla ukudla okungenawo amaprotheni amaningi
• Ukuthola amakhalori anele uma wehlisa isisindo
• Kukhawulela uketshezi
• Ukunciphisa usawoti, i-potassium, i-phosphorus, namanye ama-electrolyte

OLUNYE UKWELASHWA

Olunye ukwelashwa kuncike kwizimpawu zakho, kepha kungafaka:

• I-calcium eyengeziwe novithamini D. (Njalo khuluma nomhlinzeki wakho ngaphambi kokuthatha izithako.)
• Imithi ebizwa nge-phosphate binders, ukusiza ukuvimbela amazinga e-phosphorus ukuthi angaphakeme kakhulu.
• Ukwelashwa kwe-anemia, njenge-iron eyengeziwe ekudleni, amaphilisi e-iron noma ama-shots, isibhamu somuthi obizwa nge-erythropoietin, nokumpontshelwa igazi.
• Imithi yokulawula umfutho wegazi.

Khuluma nomhlinzeki wakho ngemigomo ongayidinga, kufaka phakathi:

• Umuthi wokugomela i-Hepatitis A.
• Umuthi wokugomela i-Hepatitis B
• Umuthi wokugomela umkhuhlane
• Umuthi wokugomela i-pneumonia (PPV)

Abanye abantu bangazuza ngokubamba iqhaza eqenjini lokuxhaswa kwezifo zezinso.

Isifo sezinso sesigaba sokugcina siholela ekufeni uma ungenayo i-dialysis noma ukufakelwa izinso. Zombili lezi zindlela zokwelapha zinezingozi. Umphumela wehlukile kumuntu ngamunye.

Izinkinga zempilo ezingabangelwa yi-ESRD zifaka:

• Ukushoda kwegazi
• Ukopha esiswini noma emathunjini
• Ubuhlungu bamathambo, obuhlangene nobomzimba
• Izinguquko kushukela wegazi (i-glucose)
• Ukulimala kwezinzwa zemilenze nezingalo
• Ukwakhela uketshezi oluzungeze amaphaphu
• Umfutho wegazi ophakeme, isifo senhliziyo, nokwehluleka kwenhliziyo
• Izinga eliphakeme le-potassium
• Ingozi eyengeziwe yokutheleleka
• Ukulimala kwesibindi noma ukwehluleka
• Ukungondleki
• Ukuphuphuma kwesisu noma ukungazali
• I-syndrome yemilenze engenakuphumula
• Unhlangothi, ukuquleka, nokuwohloka komqondo
• Ukuvuvukala ne-edema
• Ukwenza buthakathaka kwamathambo nokuqhekeka okuhlobene namazinga aphezulu we-phosphorus kanye ne-calcium ephansi

Ukwehluleka kwezinso - isigaba sokuphela; Ukwehluleka kwezinso - isigaba sokuphela; I-ESRD; ESKD

• Ukwakheka kwezinso
• I-Glomerulus nephron

IGaitonde DY, i-Cook DL, i-Rivera IM. Isifo sezinso esingapheliyo: ukuthola nokuhlola. Ngingudokotela Womndeni. 2017; 96 (12): 776-783. PMID: 29431364 www.ncbi.nlm.nih.gov/pubmed/29431364/.

I-Inker LA, Levey AS. Isiteji nokuphathwa kwesifo esingapheliyo sezinso. Ku: Gilbert SJ, Weiner DE, ama-eds. I-National Kidney Foundation Primer yezifo zezinso. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 52.

I-Taal MW. Ukwahlukaniswa kanye nokuphathwa kwesifo esingapheliyo sezinso. 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 59.

I-Yeun JY, i-Young B, i-Depner TA, i-Chin AA. Ukuhlolwa kweHemodialysis. 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 63.