Izigaba Zesifo Sezinso Esingamahlalakhona

-Delile

• Ukubuka konke kwezigaba
• Izinga lokuhlunga le-Glomerular (GFR)
• Isigaba 1 sesifo sezinso
• Izimpawu
• Ukwelashwa
• Isigaba 2 isifo sezinso
• Izimpawu
• Ukwelashwa
• Isigaba 3 sesifo sezinso
• Izimpawu
• Ukwelashwa
• Isigaba 4 sesifo sezinso
• Izimpawu
• Ukwelashwa
• Isigaba 5 sesifo sezinso
• Izimpawu
• Ukwelashwa
• Ukuhlolwa kweHemodialysis
• I-Peritoneal dialysis
• Ukuthatha ukhiye

Izinso zinemisebenzi eminingi ebalulekile empilweni enhle.Zisebenza njengezihlungi zegazi lakho, zisusa imfucuza, ubuthi kanye noketshezi oluningi.

Zisiza futhi uku:

• lawula umfutho wegazi namakhemikhali egazi
• gcina amathambo ephilile futhi kukhuthaze ukukhiqizwa kwamangqamuzana egazi abomvu

Uma unesifo esingapheliyo sezinso (CKD), ube nomonakalo ezinso zakho isikhathi esingaphezu kwezinyanga ezimbalwa. Izinso ezilimele azihluzi igazi ngendlela efanele, okungaholela ezinkingeni ezahlukahlukene zezempilo.

Kunezigaba ezinhlanu ze-CKD nezimpawu ezahlukahlukene nokwelashwa okuhambisana nesigaba ngasinye.

I-Centers for Disease Control and Prevention (CDC) ilinganisela ukuthi abantu abadala base-U.S. Bane-CKD, kodwa iningi labo alikatholakali. Kuyisimo esiqhubekayo, kepha ukwelashwa kungakunciphisa. Akuwona wonke umuntu ozoqhubekela phambili ekuhlulekeni kwezinso.

Ukubuka konke kwezigaba

Ukwabela isigaba se-CKD, udokotela wakho kumele anqume ukuthi izinso zakho zisebenza kahle kangakanani.

Enye indlela yokwenza lokhu ngokuhlolwa komchamo ukuhlola isilinganiso sakho se-albhamuin-creatinine (ACR). Kukhombisa ukuthi amaprotheni ayavuza yini emchameni (proteinuria), okuwuphawu lokulimala kwezinso.

Amazinga e-ACR ahlelwe kanjena:

Udokotela wakho angaphinde ahlele ukuhlolwa kwe-imaging, njenge-ultrasound, ukuhlola ukwakheka kwezinso zakho.

Ukuhlolwa kwegazi kukala i-creatinine, i-urea, neminye imikhiqizo edoti egazini ukubona ukuthi izinso zisebenza kanjani. Lokhu kubizwa ngokuthi isilinganiso sokuhlunga se-glomerular (eGFR). I-GFR eyi-100 mL / min ijwayelekile.

Leli thebula liqhakambisa izigaba ezinhlanu ze-CKD. Imininingwane engaphezulu ngesigaba ngasinye ilandela ithebula.

Izinga lokuhlunga le-Glomerular (GFR)

I-GFR, noma isilinganiso se-glomerular filtration, sikhombisa ukuthi izinso zakho zihlunga igazi elingakanani ngomzuzu owodwa.

Ifomula yokubala i-GFR ifaka usayizi womzimba, ubudala, ubulili, nobuhlanga. Njengoba bungekho obunye ubufakazi bezinkinga zezinso, i-GFR engaphansi kwama-60 ingabhekwa njengejwayelekile.

Izilinganiso ze-GFR zingadukisa uma, ngokwesibonelo, ungumakhi womzimba noma unenkinga yokudla.

Isigaba 1 sesifo sezinso

Esigabeni 1, kukhona ukulimala okuncane kakhulu ezinso. Ziyakwazi ukuzivumelanisa nezimo futhi zingakulungisela lokhu, okuzivumela ukuthi ziqhubeke zenze amaphesenti angama-90 noma kangcono.

Kulesi sigaba, i-CKD kungenzeka itholwe ngenhlanhla ngesikhathi sokuhlolwa kwegazi nomchamo ojwayelekile. Ungase futhi ube nalezi zivivinyo uma unesifo sikashukela noma umfutho wegazi ophakeme, izimbangela eziphezulu ze-CKD e-United States.

Izimpawu

Imvamisa, azikho izimpawu lapho izinso zisebenza ngamaphesenti angama-90 noma okungcono.

Ukwelashwa

Unganciphisa ukukhula kwesifo ngokuthatha lezi zinyathelo:

• Sebenzela ukuphatha amazinga kashukela egazini uma unesifo sikashukela.
• Landela iseluleko sikadokotela wakho sokwehlisa umfutho wegazi uma une-hypertension.
• Gcina ukudla okunempilo nokulinganisela.
• Ungasebenzisi ugwayi.
• Zivocavoce ngokomzimba imizuzu engama-30 ngosuku, okungenani izinsuku ezi-5 ngeviki.
• Zama ukugcina isisindo esifanele somzimba wakho.

Uma ungakaboni udokotela wezinso (i-nephrologist), cela udokotela wakho ojwayelekile ukuthi akuthumele komunye.

Isigaba 2 isifo sezinso

Esigabeni 2, izinso zisebenza phakathi kwamaphesenti angama-60 kuya kwangu-89.

Izimpawu

Kulesi sigaba, ungahle ungabi nazimpawu. Noma izimpawu azicacile, njenge:

• ukukhathala
• ukulunywa
• ukulahlekelwa isifiso sokudla
• izinkinga zokulala
• ubuthakathaka

Ukwelashwa

Sekuyisikhathi sokwakha ubudlelwano nodokotela wezinso. Alikho ikhambi le-CKD, kepha ukwelashwa kusenesikhathi kunganciphisa noma kumise ukuqhubeka.

Kubalulekile ukubhekana nembangela eyimbangela. Uma unesifo sikashukela, umfutho wegazi ophakeme, noma isifo senhliziyo, landela imiyalo kadokotela wakho yokuphatha lezi zimo.

Kubalulekile futhi ukugcina ukudla okunomsoco, ukuvivinya umzimba njalo, nokuphatha isisindo sakho. Uma ubhema, buza udokotela wakho ngezinhlelo zokuyeka ukubhema.

Isigaba 3 sesifo sezinso

Isigaba 3A sisho ukuthi izinso zakho zisebenza phakathi kwamaphesenti angama-45 no-59. Isigaba 3B sisho ukuthi ukusebenza kwezinso kuphakathi kwamaphesenti angama-30 kuye kwangama-44.

Izinso azihlungi imfucuza, ubuthi, noketshezi kahle futhi lokhu sekuqala ukwakha.

Izimpawu

Akuwona wonke umuntu onezimpawu esigabeni 3. Kodwa ungahle ube:

• ukuhlungu obusemhlane
• ukukhathala
• ukulahlekelwa isifiso sokudla
• ukulunywa okuphikelelayo
• izinkinga zokulala
• ukuvuvukala kwezandla nezinyawo
• uchama kakhulu noma ngaphansi kunokujwayelekile
• ubuthakathaka

Izinkinga zingafaka:

• i-anemia
• isifo samathambo
• umfutho wegazi ophakeme

Ukwelashwa

Kubalulekile ukuphatha izimo ezingaphansi ukusiza ukugcina ukusebenza kwezinso. Lokhu kungafaka:

• imishanguzo yomfutho wegazi ophezulu njenge-angiotensin-converting enzyme (ACE) inhibitors noma i-angiotensin II receptor blockers
• isisu kanye nokudla kasawoti okuphansi ukukhulula ukugcinwa koketshezi
• imithi yokwehlisa i-cholesterol
• Izithako ze-erythropoietin ze-anemia
• izengezo zikavithamini D ukubhekana namathambo abuthaka
• izibopho ze-phosphate ukuvimbela ukubalwa emithanjeni yegazi
• ukulandela ukudla okuphansi kwamaprotheni ngakho-ke izinso zakho akudingeki zisebenze kanzima

Cishe uzodinga ukuvakashelwa okulandelwayo nokuhlolwa kaningi ukuze kwenziwe izinguquko uma kudingeka.

Udokotela wakho angakudlulisela kuchwepheshe wezokudla ukuze aqiniseke ukuthi uthola zonke izakhamzimba ozidingayo.

Isigaba 4 sesifo sezinso

Isigaba 4 sisho ukuthi unokulimala kwezinso okulingene kuya kokubi kakhulu. Zisebenza phakathi kwamaphesenti ayi-15 kanye nama-29, ngakho-ke kungenzeka ukuthi wakha imfucuza eminingi, ubuthi, noketshezi emzimbeni wakho.

Kubalulekile ukuthi wenze konke okusemandleni ukuvimbela ukuqhubekela phambili ekuhlulekeni kwezinso.

Ngokwe-CDC, yabantu abanesifo esinciphe kakhulu sezinso abazi nokuthi banaso.

Izimpawu

Izimpawu zingafaka:

• ukuhlungu obusemhlane
• ubuhlungu besifuba
• ukuncipha kokucija kwengqondo
• ukukhathala
• ukulahlekelwa isifiso sokudla
• izicubu zemisipha noma amajaqamba
• isicanucanu nokuhlanza
• ukulunywa okuphikelelayo
• ukuphelelwa umoya
• izinkinga zokulala
• ukuvuvukala kwezandla nezinyawo
• uchame kakhulu noma ngaphansi kunokujwayelekile
• ubuthakathaka

Izinkinga zingafaka:

• i-anemia
• isifo samathambo
• umfutho wegazi ophakeme

Usengozini eyengeziwe yesifo senhliziyo nesifo sohlangothi.

Ukwelashwa

Esigabeni 4, kuzodingeka usebenze ngokusondelene kakhulu nodokotela bakho. Ngokungeziwe ekwelashweni okufanayo nasezigabeni zangaphambilini, kufanele uqale izingxoxo mayelana ne-dialysis nokufakelwa kwezinso uma izinso zakho zingaphumeleli.

Lezi zinqubo zithatha ukuhleleka ngokucophelela nesikhathi esiningi, ngakho-ke kuwukuhlakanipha ukuba nohlelo olubekiwe manje.

Isigaba 5 sesifo sezinso

Isigaba 5 sisho ukuthi izinso zakho zisebenza ngaphansi kwamaphesenti ayi-15 umthamo noma ukwehluleka kwezinso.

Uma lokho kwenzeka, inqwaba yemfucuza nobuthi kusongela impilo. Lesi yisifo se-renal sokugcina.

Izimpawu

Izimpawu zokwehluleka kwezinso zingafaka:

• ubuhlungu bomhlane nesifuba
• izinkinga zokuphefumula
• ukuncipha kokucija kwengqondo
• ukukhathala
• ukungafuni ukudla
• izicubu zomzimba noma amajaqamba
• isicanucanu noma ukuhlanza
• ukulunywa okuphikelelayo
• inkathazo yokulala
• ubuthakathaka obukhulu
• ukuvuvukala kwezandla nezinyawo
• uchama kakhulu noma ngaphansi kunokujwayelekile

Ingozi yesifo senhliziyo nesifo sohlangothi iyakhula.

Ukwelashwa

Uma usuphelele ukuhluleka kwezinso, isikhathi sokuphila izinyanga ezimbalwa kuphela ngaphandle kwe-dialysis noma ukufakelwa izinso.

I-Dialysis ayilona ikhambi lesifo sezinso, kodwa inqubo yokususa imfucuza noketshezi egazini lakho. Kunezinhlobo ezimbili ze-dialysis, i-hemodialysis ne-peritoneal dialysis.

Ukuhlolwa kweHemodialysis

I-Hemodialysis yenziwa esikhungweni se-dialysis ngohlelo olubekiwe, imvamisa kathathu ngesonto.

Ngaphambi kokwelashwa ngakunye, kufakwa izinaliti ezimbili engalweni yakho. Zinamathiselwe kwi-dialyzer, kwesinye isikhathi ebizwa ngokuthi yinso yokufakelwa. Igazi lakho lishaywa ngesihlungi bese libuyiselwa emzimbeni wakho.

Ungaqeqeshelwa ukwenza lokhu ekhaya, kepha kudinga inqubo yokuhlinza ukudala ukutholwa kwemithambo. I-dialysis yasekhaya yenziwa kaningi kune-dialysis esikhungweni sokwelashwa.

I-Peritoneal dialysis

Nge-peritoneal dialysis, uzoba ne-catheter ngokuhlinzwa ngokufakwa esiswini sakho.

Ngesikhathi sokwelashwa, isisombululo se-dialysis singena nge-catheter singene esiswini, ngemuva kwalokho ungahamba ngosuku lwakho olujwayelekile. Ngemuva kwamahora ambalwa, ungakhipha i-catheter esikhwameni bese usilahla. Lokhu kufanele kuphindwe izikhathi ezi-4 kuya kwezi-6 ngosuku.

Ukufakelwa kwezinso kubandakanya ukufaka esikhundleni sezinso zakho okunempilo. Izinso zingaqhamuka kubaxhasi abaphilayo noma abangasekho. Ngeke udinge i-dialysis, kodwa kuzofanele uthathe imishanguzo yokulwa nokwenqatshwa impilo yakho yonke.

Ukuthatha ukhiye

Kunezigaba ezi-5 zesifo esingapheliyo sezinso. Izigaba zinqunywa ngokuhlolwa kwegazi nomchamo kanye nezinga lokulimala kwezinso.

Yize kuyisifo esiqhubekela phambili, akuwona wonke umuntu ozoqhubeka nokuthuthukisa ukwehluleka kwezinso.

Izimpawu zesifo sezinso sesigaba sokuqala zincane futhi zinganakwa kalula. Yingakho kubalulekile ukuthi uhlolwe njalo uma unesifo sikashukela noma umfutho wegazi ophezulu, okuyizimbangela ezihamba phambili zezifo zezinso.

Ukuxilongwa kusenesikhathi nokuphathwa kwezimo ezikhona kungasiza ekunciphiseni noma ekuvimbeleni ukuqhubeka.