Konke Okufanele Ukwazi NgeSigaba 2 Sesifo Sezinso

-Delile

• Ukuhlonza isigaba sesifo esingapheliyo sezinso
• Isigaba 2 izimpawu zesifo sezinso
• Izimbangela zesigaba sesibili sesifo sezinso
• Uzoyibona nini udokotela onesifo sezinso sesigaba 2
• Ukwelashwa kwesifo sesinso sesigaba 2
• Isigaba 2 Ukudla kwesifo sezinso
• Amakhambi asekhaya
• Ukwelashwa
• Ukuphila nesifo sesinso sesigaba 2
• Ngabe isigaba sesibili sezinso singabuyiselwa emuva?
• Isigaba 2 sesikhathi sokugula sesifo sezinso
• Ukudla okudlela endlini

Isifo sezinso esingapheli, esibizwa nangokuthi i-CKD, siwuhlobo lokulimala isikhathi eside ezinso. Kubonakala ngomonakalo waphakade oqhubeka esikalini sezigaba ezinhlanu.

Isigaba 1 sisho ukuthi unenani elincane kakhulu lokulimala kwezinso, kanti isigaba 5 (isigaba sokugcina) sisho ukuthi ufake ukuhluleka kwezinso. Ukuxilongwa kwesigaba 2 CKD kusho ukuthi unomonakalo omncane.

Inhloso yokuxilongwa nokwelashwa kwe-CKD ukumisa ukuqhubeka kokulimala okwengeziwe kwezinso. Ngenkathi ungeke ukwazi ukuguqula umonakalo kunoma yisiphi isigaba, ukuba nesigaba 2 CKD kusho ukuthi usenethuba lokukuvimba ukuthi ungabi kubi kakhulu.

Funda kabanzi mayelana nezici zalesi sigaba sesifo sezinso, kanye nezinyathelo ongazithatha manje ukusiza ukuvimbela isimo sakho ukuthi seqe isigaba sesibili.

Ukuhlonza isigaba sesifo esingapheliyo sezinso

Ukuthola isifo sezinso, udokotela uzohlola igazi elibizwa ngokuthi isilinganiso sokuhlunga se-glomerular (eGFR). Lokhu kukala inani le-creatine, i-amino acid, egazini lakho, elingatshela ukuthi izinso zakho zihlunga imfucuza yini.

Izinga le-creatinine eliphakeme ngokungajwayelekile lisho ukuthi izinso zakho azisebenzi ezingeni elilungile.

Ukufundwa kwe-EGFR okungama-90 noma ngaphezulu kwenzeka esigabeni 1 CKD, lapho kukhona ukulimala kwezinso okuncane kakhulu. Ukwehluleka kwezinso kubonakala ekufundweni kwe-15 noma ngezansi. Ngesigaba 2, ukufundwa kwakho kwe-eGFR kuzokwehla phakathi kuka-60 no-89.

Akunandaba ukuthi isifo sakho sezinso sihlukaniswa kusiphi isigaba, inhloso ukuthuthukisa ukusebenza kwezinso ngokuphelele nokuvikela ukulimala okuqhubekayo.

Ukuhlolwa njalo kwe-eGFR kungaba yinkomba yokuthi uhlelo lwakho lokwelashwa luyasebenza yini. Uma uthuthukela esigabeni sesi-3, ukufundwa kwakho kwe-eGFR kungalinganisa phakathi kuka-30 no-59.

Isigaba 2 izimpawu zesifo sezinso

Ukufundwa kwe-EGFR esiteji sesi-2 kusacatshangelwa ngaphakathi kobubanzi bokusebenza kwezinso “ezijwayelekile”, ngakho-ke kungaba nzima ukuthola lesi sifo sesifo sezinso esingalapheki.

Uma uphakamise amazinga e-eGFR, ungahle ube namazinga aphezulu e-creatinine emchameni wakho uma ulimele izinso.

Isigaba 2 i-CKD ubukhulu becala asymptomatic, ngezimpawu eziningi ezingabonakali kuze kube yilapho isimo sakho sesithuthukele esigabeni sesi-3.

Izimpawu ezingaba khona zifaka:

• umchamo omnyama ongahlukahluka phakathi kombala ophuzi, obomvu, nowolintshi
• ukwanda noma ukwehla kokuchama
• ukukhathala ngokweqile
• umfutho wegazi ophakeme
• ukugcinwa kwamanzi (edema)
• ubuhlungu emhlane ongezansi
• amajaqamba ebusuku
• ukuqwasha
• isikhumba esomile noma esilumayo

Izimbangela zesigaba sesibili sesifo sezinso

Isifo sezinso uqobo sidalwa yizinto ezinciphisa ukusebenza kwezinso, okudala ukulimala kwezinso. Lapho lezi zitho ezibalulekile zingasebenzi kahle, azikwazi ukukhipha imfucuza egazini futhi zikhiqize umkhiqizo ofanele womchamo.

I-CKD ayijwayele ukutholakala esiteji 1 ngoba kunomonakalo omncane kakhulu okungenzeki ukuthi kube nezimpawu ezanele zokuyithola. Isigaba 1 singaguqulela esigabeni 2 lapho kukhona ukwehla kokusebenza noma ukulimala okungaba khona emzimbeni.

Izimbangela ezivame kakhulu zesifo sezinso zifaka:

• umfutho wegazi ophakeme
• isifo sikashukela
• ukutheleleka okuphindaphindiwe komchamo
• umlando wamatshe ezinso
• izimila noma ama-cysts ezinso nasezindaweni ezizungezile
• lupus

Uma izimo ezingenhla zishiywa zingalashwa, kulimala kakhulu izinso zakho.

Uzoyibona nini udokotela onesifo sezinso sesigaba 2

Njengoba isifo sezinso esimnene singenazo izimpawu eziningi ezibonakalayo njengezinyathelo ezithuthukile, ungahle ungaboni ukuthi unesigaba 2 CKD kuze kube ngokomzimba wakho wonyaka.

Umlayezo obalulekile lapha ukuthi abantu abadala kufanele babe nobudlelwano obuqhubekayo nodokotela wokunakekelwa okuyisisekelo. Ngokungeziwe ekuhlolweni kwakho okujwayelekile, kufanele futhi ubone udokotela wakho uma uhlangabezana nanoma yiziphi izimpawu ezishiwo ngenhla.

Udokotela futhi uzoqapha impilo yakho yezinso ngokucophelela uma unezinto ezinobungozi noma umlando womndeni wesifo sezinso.

Ngaphezu kokuhlolwa kwegazi nomchamo, udokotela angenza ukuhlolwa kwe-imaging, njenge-renal ultrasound. Lezi zivivinyo zizosiza ekunikezeni ukubheka okungcono izinso zakho ukuhlola ubukhulu bomonakalo.

Ukwelashwa kwesifo sesinso sesigaba 2

Uma sekonakele izinso, awukwazi ukukuguqula. Noma kunjalo, wena can vimbela ukuqhubeka okuqhubekayo. Lokhu kufaka inhlanganisela yezinguquko zendlela yokuphila nemithi yokusiza ukuphatha izimbangela eziyisisekelo zesigaba 2 CKD.

Isigaba 2 Ukudla kwesifo sezinso

Ngenkathi kungekho kudla okukodwa okutholakalayo okungakwazi "ukwelapha" isigaba 2 CKD, ukugxila ekudleni okulungile nokugwema okunye kungasiza ukukhulisa ukusebenza kwezinso.

Okunye ukudla okubi kakhulu kwezinso zakho kufaka:

• ukucutshungulwa, amabhokisi, nokudla okusheshayo
• ukudla okuqukethe inani eliphakeme le-sodium
• amafutha agcwele
• dlulisa inyama

Udokotela futhi angancoma ukuthi unciphise imithombo yamaprotheni esezilwaneni nasezitshalweni uma udla inani eleqile. Amaprotheni amaningi kakhulu anzima ezinso.

Esigabeni 2 CKD, kungenzeka ungadingi ukulandela eminye yemikhawulo enconyelwe isifo sesifo esithuthuke kakhulu, njengokugwema i-potassium.

Esikhundleni salokho, ukugxila kwakho kufanele kube ekugcineni kokudla kokudla okusha, okuphelele okuvela emithonjeni elandelayo:

• okusanhlamvu okuphelele
• ubhontshisi nemidumba
• izinkukhu ezinamafutha
• inhlanzi
• imifino nezithelo
• amafutha asezitshalweni

Amakhambi asekhaya

Amakhambi asekhaya alandelayo angagcwalisa ukudla okunempilo kwesigaba 2 sokuphathwa kwe-CKD:

• ukuthatha izithako zensimbi ukwelapha i-anemia nokuthuthukisa ukukhathala
• ukuphuza amanzi amaningi
• ukudla ukudla okuncane usuku lonke
• ukwenza ukuphathwa kwengcindezi
• ukuzivocavoca nsuku zonke

Ukwelashwa

Inhloso yemithi yesigaba sesi-2 i-CKD ukuphatha izimo ezingaphansi ezingaba nomthelela ekulimaleni kwezinso.

Uma unesifo sikashukela, uzodinga ukuqapha i-glucose yakho ngokucophelela.

Ama-Angiotensin II receptor blockers (ama-ARB) noma ama-angiotensin aguqula i-enzyme (ACE) inhibitors angalapha umfutho wegazi ophezulu odala i-CKD.

Ukuphila nesifo sesinso sesigaba 2

Ukuvimbela ukuqhubeka kwesifo sezinso kungazizwa njengomsebenzi owesabekayo. Kubalulekile ukwazi ukuthi ukukhetha okuncane okwenzayo nsuku zonke kungathinta ngempela isithombe esikhulu sempilo yakho yonke yezinso. Ungaqala ngo:

• ukuyeka ukubhema (okuvame ukuba nzima, kepha udokotela angakha uhlelo lokuyeka olulungele wena)
• ukusika utshwala (udokotela angasiza nalokhu futhi)
• ukwenza amasu okuphatha ukucindezela, njenge-yoga nokuzindla
• ukuzivocavoca okungenani imizuzu engama-30 nsuku zonke
• ukuhlala unamanzi amaningi

Ngabe isigaba sesibili sezinso singabuyiselwa emuva?

Kwesinye isikhathi, isifo sezinso singatholwa ukuthi sibangelwa inkinga ethile yesikhashana, njengomphumela oseceleni womuthi noma ukuvinjelwa. Lapho imbangela ikhonjwa, kungenzeka ukuthi ukusebenza kwezinso kungathuthuka ngokwelashwa.

Alikho ikhambi lesifo sezinso esiholele ekulimaleni unomphela, kufaka phakathi amacala amancane atholwe njengesigaba 2. Kodwa-ke, ungathatha isinyathelo manje ukugwema ukuqhubeka okuqhubekayo. Kungenzeka ube ne-2 CKD yesigaba futhi uyivimbele ukuthi iqhubekele esigabeni 3.

Isigaba 2 sesikhathi sokugula sesifo sezinso

Abantu abasesigabeni sesi-2 sesifo sezinso kusacatshangwa ukuthi banomsebenzi wezinso ophilile jikelele. Ngakho-ke ukubikezela kungcono kakhulu uma kuqhathaniswa nezigaba ezithuthuke kakhulu ze-CKD.

Umgomo-ke ukuvimbela ukuqhubeka okuqhubekayo. Njengoba i-CKD iba yimbi kakhulu, ingadala nezinkinga ezisongela impilo, njengesifo senhliziyo.

Ukudla okudlela endlini

Isigaba sesi-2 i-CKD ibhekwa njengehlobo elincane lesifo sezinso, futhi ungahle ungaziboni izimpawu. Kodwa-ke lokhu kungenza futhi ukuthi lesi sigaba kube nzima ukusibona nokuselapha.

Njengomthetho wesithupha, uzofuna ukuqinisekisa ukuthi uhlolwa njalo egazini nasemchameni uma unezimo ezithile noma umlando womndeni okwandisa ubungozi bakho be-CKD.

Uma usutholwe ukuthi une-CKD, ukumisa ukuqhubeka kokulimala kwezinso kuncike ekuguqulweni kwendlela yokuphila. Khuluma nodokotela wakho mayelana nokuthi ungaqala kanjani ngokunciphisa umzimba nokuzivocavoca ngesimo sakho.