I-Glomerulonephritis (Izifo Eziqhakazile)

-Delile

• Ziyini izimbangela ze-GN?
• I-Acute GN
• I-GN engapheli
• Ziyini izimpawu ze-GN?
• I-Acute GN
• I-GN engapheli
• Ukuhluleka kwezinso
• Ixilongwa kanjani i-GN?
• Yiziphi izindlela zokwelapha ezitholakalayo ze-GN?
• Yiziphi izinkinga ezihambisana ne-GN?
• Uyini umbono wesikhathi eside?

Kuyini i-glomerulonephritis?

IGlomerulonephritis (GN) ukuvuvukala kwama-glomeruli, okuyizakhiwo ezinsweni zakho ezakhiwa yimithambo yegazi emincane. La mafindo emikhumbi asiza ukuhlunga igazi lakho futhi asuse uketshezi oluningi. Uma i-glomeruli yakho yonakele, izinso zakho zizoyeka ukusebenza kahle, futhi ungangena ekuhlulekeni kwezinso.

Kwesinye isikhathi esibizwa nge-nephritis, i-GN yisifo esibi esingasongela impilo futhi esidinga ukwelashwa ngokushesha. I-GN ingaba yomibili, noma engazelelwe, futhi engapheli, noma yesikhathi eside. Lesi simo sasaziwa njengesifo sikaBright.

Funda ukuze ufunde ukuthi yini ebangela i-GN, itholakala kanjani, nokuthi yiziphi izinketho zokwelashwa.

Ziyini izimbangela ze-GN?

Izimbangela ze-GN zincike ekutheni zinzima noma zingelapheki.

I-Acute GN

I-Acute GN ingaba yimpendulo ekuthelelekeni okufana ne-strep throat noma izinyo eliphume. Kungenzeka ngenxa yezinkinga amasosha akho omzimba asabela ngokweqile ekutheleleni. Lokhu kungaphela ngaphandle kokwelashwa. Uma ingapheli, ukwelashwa okusheshayo kuyadingeka ukuvimbela ukulimala kwesikhathi eside ezinso zakho.

Ukugula okuthile kwaziwa ngokudala i-GN enamandla, kufaka phakathi:

• strep umphimbo
• systemic lupus erythematosus, ebizwa nangokuthi lupus
• I-Goodpasture syndrome, isifo esingajwayelekile somzimba lapho amasosha omzimba ahlasela izinso namaphaphu akho
• i-amyloidosis, eyenzeka lapho amaprotheni angajwayelekile angadala ingozi akhe izitho zakho nezicubu zakho
• i-granulomatosis ne-polyangiitis (phambilini ebiyaziwa nge-Wegener’s granulomatosis), isifo esingajwayelekile esidala ukuvuvukala kwemithambo yegazi
• i-polyarteritis nodosa, isifo lapho amaseli ehlasela khona imithambo yegazi

Ukusetshenziswa kanzima kwezidakamizwa ezingezona ukuvuvukala, ezifana ne-ibuprofen (Advil) ne-naproxen (Aleve), nakho kungaba yingozi. Akufanele weqe isilinganiso nobude bokwelashwa obubhalwe ebhodleleni ngaphandle kokufuna iseluleko kumhlinzeki wakho wokunakekela oyinhloko.

I-GN engapheli

Ifomu elingapheli le-GN lingakhula ngaphezu kweminyaka eminingana ngaphandle kwezimpawu ezimbalwa noma ezimbalwa kakhulu. Lokhu kungadala ukulimala okungenakulungiseka ezinso zakho futhi ekugcineni kuholele ekuqedeni ukwehluleka kwezinso.

I-GN engapheli ayinaso isizathu esicacile ngaso sonke isikhathi. Isifo sofuzo kwesinye isikhathi singadala i-GN engapheli. I-nephritis ezuzwe njengefa ivela ezinsizweni ezingaboni kahle futhi ezingezwa kahle. Ezinye izimbangela kungenzeka zifaka:

• izifo ezithile zomzimba
• umlando womdlavuza
• ukuvezwa kwamanye ama-solvents e-hydrocarbon

Futhi, ukuba nefomu elibi le-GN kungakwenza ube sethubeni lokuthuthukisa i-GN engapheli ngokuhamba kwesikhathi.

Ziyini izimpawu ze-GN?

Izimpawu ongahlangabezana nazo zincike kunhloboni ye-GN onayo nokuthi inzima kangakanani.

I-Acute GN

Izimpawu zokuqala ze-GN enamandla zifaka:

• ukukhukhumala ebusweni bakho
• ukuchama kaningi
• igazi emchameni wakho, okwenza umchamo wakho umbala wokugqwala omnyama
• uketshezi olungeziwe emaphashini akho, okudala ukukhwehlela
• umfutho wegazi ophakeme

I-GN engapheli

Ifomu elingapheli le-GN lingangena ngaphandle kwezimpawu. Kungahle kube nokuthuthuka okuhamba kancane kwezimpawu ezifana nefomu elibi. Ezinye izimpawu zifaka:

• igazi noma amaprotheni amaningi ngokweqile emchameni wakho, okungaba yi-microscopic futhi kuvele ekuhlolweni komchamo
• umfutho wegazi ophakeme
• ukuvuvukala emaqakaleni nasebusweni
• ukuchama kaningi ebusuku
• umchamo we-bubbly noma we-foamy, kusuka kumaprotheni amaningi
• ubuhlungu besisu
• ukopha kaningi

Ukuhluleka kwezinso

I-GN yakho ingahle ithuthuke kakhulu kangangokuba uhlakulele ukwehluleka kwezinso. Ezinye zezimpawu zalokhu zibandakanya:

• ukukhathala
• ukungabi nesifiso sokudla
• isicanucanu nokuhlanza
• ukuqwasha
• isikhumba esomile, esilumayo
• amajaqamba ebusuku

Ixilongwa kanjani i-GN?

Isinyathelo sokuqala sokuxilongwa ukuhlolwa kwe-urinalysis. Igazi namaprotheni emchameni yizimpawu ezibalulekile zalesi sifo. Ukuhlolwa komzimba okujwayelekile kwesinye isimo kungaholela ekutholeni i-GN.

Ukuhlolwa okwengeziwe komchamo kungadingeka ukuhlola izimpawu ezibalulekile zempilo yezinso, kufaka phakathi:

• imvume ye-creatinine
• amaprotheni esewonke emchameni
• ukugxila komchamo
• umchamo gravity ethize
• umchamo amaseli abomvu egazi
• umchamo osmolality

Ukuhlolwa kwegazi kungakhombisa:

• i-anemia, okuyizinga eliphansi lamaseli abomvu egazi
• amazinga angajwayelekile we-albhamuin
• igazi elingajwayelekile urea nitrogen
• amazinga aphezulu e-creatinine

Udokotela wakho angaphinde ayalele ukuhlolwa kwe-immunology ukuze uhlole:

• ama-antibodies ulwelwesi lwangaphansi kwamagciwane
• amasosha omzimba antineutrophil cytoplasmic
• amasosha omzimba aphikisayo
• gcwalisa amazinga

Imiphumela yalokhu kuhlolwa ingakhombisa ukuthi amasosha omzimba wakho alimaza izinso zakho.

I-biopsy yezinso zakho kungadingeka ukuqinisekisa ukuxilongwa. Lokhu kuhilela ukuhlaziya isampula elincane lezicubu zezinso ezithathwe ngenaliti.

Ukuze ufunde kabanzi ngesimo sakho, ungahle ube nokuhlolwa kwe-imaging njengokulandelayo:

• Iskena se-CT
• i-ultrasound yezinso
• X-ray esifubeni
• i-pyelogram efakwa emithanjeni

Yiziphi izindlela zokwelapha ezitholakalayo ze-GN?

Izinketho zokwelashwa zincike ohlotsheni lwe-GN obhekene nalo nembangela yalo.

Enye indlela yokwelapha ukulawula umfutho wegazi ophakeme, ikakhulukazi uma lokho kuyimbangela eyisisekelo ye-GN. Umfutho wegazi ungaba nzima ukulawula uma izinso zakho zingasebenzi kahle. Uma kunjalo, udokotela wakho angakunika imishanguzo yegazi, kufaka phakathi i-angiotensin-converting enzyme inhibitors, noma i-ACE inhibitors, efana:

• bongiwe
• i-lisinopril (iZestril)
• i-perindopril (Aceon)

Udokotela wakho angaphinde anikeze ama-angiotensin receptor blockers, noma ama-ARB, anjenge:

• i-losartan (Cozaar)
• I-irbesartan (Avapro)
• i-valsartan (Diovan)

ICorticosteroids nayo ingasetshenziswa uma amasosha akho omzimba ehlasela izinso zakho. Zinciphisa ukuphendula komzimba.

Enye indlela yokunciphisa ukuvuvukala okubangelwa amasosha omzimba yi-plasmapheresis. Le nqubo isusa ingxenye engamanzi yegazi lakho, ebizwa ngokuthi i-plasma, bese iyifaka esikhundleni samanzi afakwa emithanjeni noma i-plasma enikelwe engenawo ama-antibody.

Nge-GN engapheli, uzodinga ukunciphisa inani lamaprotheni, usawoti, ne-potassium ekudleni kwakho. Ngokwengeziwe, kufanele ubuke ukuthi uphuza okungakanani uketshezi. Kunganconywa izithasiselo ze-calcium, futhi kungadingeka ukuthi uthathe imishanguzo yokwelapha ukunciphisa ukuvuvukala. Buza udokotela wakho jikelele noma uchwepheshe wezinso ukuthola imihlahlandlela mayelana nemikhawulo yokudla noma izengezo. Bangakusetha nodokotela wezokudla wezokwelapha ukuze bakweluleke ngezinketho zakho.

Uma isimo sakho sithuthuka futhi uba nokuhluleka kwezinso, kungadingeka ukuthi ube ne-dialysis. Kule nqubo, umshini uhlunga igazi lakho. Ekugcineni, ungadinga ukufakelwa izinso.

Yiziphi izinkinga ezihambisana ne-GN?

I-GN ingaholela ku-nephrotic syndrome, edala ukuthi ulahlekelwe amaprotheni amaningi emchameni wakho. Lokhu kuholela ekugcineni uketshezi oluningi nosawoti emzimbeni wakho. Ungaba nomfutho wegazi ophakeme, i-cholesterol ephezulu nokuvuvukala emzimbeni wakho wonke. AmaCorticosteroids alapha lesi simo. Ekugcineni, i-nephrotic syndrome izoholela esigabeni sokugcina sesifo sezinso uma singalawulwa.

Lezi zimo ezilandelayo zingenzeka futhi ngenxa ye-GN:

• ukwehluleka okukhulu kwezinso
• isifo esingapheliyo sezinso
• ukungalingani kwe-electrolyte, njengamazinga aphezulu we-sodium noma i-potassium
• izifo ezingapheli zomgudu womchamo
• ukuhluleka kwenhliziyo ngenxa yokugcinwa oketshezi oketshezi noma oketshezi
• i-edema yamaphaphu ngenxa yokugcinwa oketshezi oketshezi noma oketshezi
• umfutho wegazi ophakeme
• umfutho ophakeme wegazi, okhuphula umfutho wegazi ophakeme ngokushesha
• ingozi eyengeziwe yokutheleleka

Uyini umbono wesikhathi eside?

Uma ibanjwe kusenesikhathi, i-GN ebukhali ingaba yesikhashana futhi ingaguqulwa. I-GN engalapheki inganciphisa ukwelashwa ngaphambi kwesikhathi. Uma i-GN yakho iba yimbi, kungenzeka iholele ekwehliseni ukusebenza kwezinso, ukwehluleka kwezinso okungamahlalakhona, kanye nesifo sezinso sokugcina.

Ukulimala okukhulu kwezinso, ukwehluleka kwezinso, kanye nesifo sezinso sokugcina ekugcineni kungadinga i-dialysis kanye nokufakelwa kwezinso.

Lokhu okulandelayo yizinyathelo ezinhle ongazilulama ku-GN futhi uvikele iziqephu ezizayo:

• Gcina isisindo esinempilo.
• Nciphisa usawoti ekudleni kwakho.
• Vimbela amaprotheni ekudleni kwakho.
• Vimbela i-potassium ekudleni kwakho.
• Yeka ukubhema.

Ngaphezu kwalokho, ukuhlangana neqembu elixhasayo kungaba yindlela ewusizo yokuthi ubhekane nengcindezi engokomzwelo yokuba nesifo sezinso.