I-Nephrogenic diabetes insipidus

I-Nephrogenic diabetes insipidus (NDI) yisifo lapho ukukhubazeka kumashubhu amancane (ama-tubules) ezinso kubangela ukuthi umuntu adlulise umchamo omkhulu futhi alahlekelwe ngamanzi amaningi.

Imvamisa, ama-tubules ezinso avumela amanzi amaningi egazini ukuthi ahlungwe abuyiselwe egazini.

I-NDI yenzeka lapho izigaxa zezinso zingaphenduli kwi-hormone esemzimbeni ebizwa nge-antidiuretic hormone (ADH), ebizwa nangokuthi i-vasopressin. I-ADH imvamisa idala izinso ukuthi zenze umchamo ugxile kakhulu.

Ngenxa yokungaphenduli kwisiginali ye-ADH, izinso zikhipha amanzi amaningi emchameni. Lokhu kudala ukuthi umzimba ukhiqize inani elikhulu lomchamo ohlanjululwe kakhulu.

I-NDI ayivamile kakhulu. I-congenital nephrogenic diabetes insipidus ikhona lapho izalwa. Kungumphumela wesici esidluliselwe emindenini. Abesilisa bavame ukuthinteka, yize abesifazane bengaludlulisela lolu hlobo ezinganeni zabo.

Imvamisa, i-NDI iba ngenxa yezinye izizathu. Lokhu kubizwa ngokuthi yisifo esitholakele. Izici ezingadala ifomu elitholakele lalesi simo zifaka:

• Ukuvinjelwa komgudu womchamo
• Amazinga aphezulu e-calcium
• Amazinga aphansi e-potassium
• Ukusetshenziswa kwemithi ethile (i-lithium, i-demeclocycline, i-amphotericin B)

Ungaba nokoma okukhulu noma okungalawuleki, futhi ulangazelele amanzi eqhwa.

Uzokhiqiza inani elikhulu lomchamo, imvamisa ngaphezu kwamalitha ama-3, kuze kufike kumalitha ayi-15 ngosuku. Umchamo uhlanjululwe kakhulu futhi ubukeka ucishe ufane namanzi. Ungadinga ukuchama njalo ngehora noma nangaphezulu, ngisho nasebusuku lapho ungadli noma ungaphuzi kakhulu.

Uma ungaphuzi uketshezi olwanele, kungaholela ekuphelelweni amanzi emzimbeni. Izimpawu zingafaka:

• Ulwelwesi lwamafinyila olomile
• Isikhumba esomile
• Ukubukeka okumanzi emehlweni
• I-Slinen fontanelles (indawo ethambile) ezinganeni
• Izinguquko kwimemori noma kubhalansi

Ezinye izimpawu ezingenzeka ngenxa yokushoda koketshezi, okudala ukomisa, zifaka:

• Ukukhathala, ukuzizwa ubuthakathaka
• Ubuhlungu bekhanda
• Ukuthukuthela
• Izinga lokushisa lomzimba eliphansi
• Ubuhlungu bemisipha
• Ukushaya kwenhliziyo okusheshayo
• Ukwehla kwesisindo
• Ushintsho ekuxwayeni, ngisho nase-coma

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola abuze ngezimpawu zakho noma zengane yakho.

Ukuhlolwa komzimba kungaveza:

• Umfutho wegazi ophansi
• Ukushaya ngamandla okusheshayo
• Ukushaqeka
• Izimpawu zokuphela kwamanzi emzimbeni

Izivivinyo zingaveza:

• I-serum osmolality ephezulu
• Ukukhishwa okuphezulu komchamo, noma ngabe uphuza okungakanani uketshezi
• Izinso aziwugxili umchamo lapho unikezwa i-ADH (imvamisa umuthi obizwa nge-desmopressin)
• Umchamo osmolality ophansi
• Amazinga ajwayelekile noma aphezulu we-ADH

Olunye uvivinyo olungenziwa lubandakanya:

• Ukuhlolwa kwegazi le-Sodium
• Umthamo wamahora angama-24
• Ukuhlolwa kokuhlushwa komchamo
• Umchamo wamandla adonsela phansi womchamo
• Ukuhlolwa kokuphucwa kwamanzi okugadiwe
  

Inhloso yokwelashwa ukulawula amazinga oketshezi lomzimba. Kuzonikezwa inani elikhulu loketshezi. Inani kufanele licishe lilingane nenani lamanzi alahlekile emchameni.

Uma isimo singenxa yomuthi othile, ukumisa umuthi kungathuthukisa izimpawu. Kodwa, UNGAYEKI ukuthatha noma imuphi umuthi ngaphandle kokuqala ukhulume nomhlinzeki wakho.

Imithi inganikezwa ukwenza ngcono izimpawu ngokunciphisa ukuphuma komchamo.

Uma umuntu ephuza amanzi anele, lesi simo ngeke sibe nomthelela omkhulu kubhalansi woketshezi noma we-electrolyte womzimba. Kwesinye isikhathi, ukudlulisa umchamo omningi isikhathi eside kungadala ezinye izinkinga ze-electrolyte.

Uma umuntu engaphuzi uketshezi olwanele, ukukhishwa komchamo omkhulu kungadala ukoma namazinga aphezulu esodium egazini.

I-NDI ekhona ngesikhathi sokuzalwa iyisimo sesikhathi eside esidinga ukwelashwa impilo yonke.

Uma ingalashwa, i-NDI ingadala noma ikuphi kokulandelayo:

• Ukuhlukaniswa kwama-ureters nesinye
• I-sodium ephezulu yegazi (hypernatremia)
• Ukuphela kwamanzi emzimbeni
• Ukushaqeka
• I-Coma

Shayela umhlinzeki wakho uma wena noma ingane yakho unezimpawu zalesi sifo.

I-NDI ye-Congenital ayinakuvinjelwa.

Ukwelapha ukuphazamiseka okungaholela kufomu elitholakele lesimo kungasivimba ukuthi singakhuli kwezinye izimo.

I-Nephrogenic diabetes insipidus; I-nephrogenic diabetes insipidus etholakele; Isifo sikashukela esizalwa naso se-nephrogenic insipidus; I-NDI

• Uhlelo lwesilisa lomchamo

I-Bockenhauer D. Uketshezi lwe-fluid, i-electrolyte, ne-acid-base ezinganeni. 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 73.

IBreault DT, Majzoub JA. Isifo sikashukela insipidus. 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 574.

UHannon MJ, uThompson CJ. IVasopressin, isifo sikashukela insipidus, kanye nesifo se-antidiuresis esingafanele. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 18.

Isikimu SJ. Izinkinga zokuthuthwa kwezinso ezisekelwe kwizakhi zofuzo. Ku: Gilbert SJ, Weiner DE, ama-eds. I-Primer yezifo zezinso iNational Kidney Foundation. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 38.