Konke Okufanele Ukwazi NgeSigaba 3 Sezifo Zezinso

-Delile

• Isifo sesifo sezinso esingapheli isigaba 3
• Isigaba 3 izimpawu zesifo sezinso
• Uzoyibona nini udokotela onesigaba 3 CKD
• Ukwelashwa kwesifo sesinso esiteji 3
• Isigaba 3 Ukudla kwesifo sezinso
• Ukwelashwa
• Ukuphila nesifo sesinso sesigaba 3
• Ngabe isigaba sesithathu sezinso singabuyiselwa emuva?
• Isigaba 3 sesikhathi sokuphila sesifo sezinso
• Ukuthatha

Isifo sezinso esingalapheki (CKD) sisho ukulimala unomphela ezinso ezenzeka kancane kancane ngokuhamba kwesikhathi. Ukuqhubeka okuqhubekayo kungavikeleka ngokuya ngesigaba saso.

I-CKD ihlukaniswa ngezigaba ezinhlanu ezihlukene, ngesigaba 1 esikhombisa ukusebenza okuhle kakhulu, nesigaba sesi-5 esikhombisa ukwehluleka kwezinso.

Isigaba 3 sesifo sezinso siwela maphakathi nendawo. Kulesi sigaba, izinso zinomonakalo omncane ukuya kokulingene.

Isifo sezinso sesigaba 3 sitholwa udokotela ngokuya ngezimpawu zakho kanye nemiphumela yelab. Ngenkathi ungeke ukwazi ukubuyisela emuva ukulimala kwezinso, ungasiza ekuvimbeleni ukulimala ukuthi kungabi kubi kulesi sigaba.

Funda ukuze uthole ukuthi odokotela banquma kanjani isigaba se-CKD, yiziphi izinto ezithinta umphumela, nokuningi.

Isifo sesifo sezinso esingapheli isigaba 3

Isigaba 3 se-CKD sitholakala ngokusekelwe ekufundweni okulinganiselwe kwe-glomerular filtration rate (eGFR). Lokhu ukuhlolwa kwegazi okulinganisa amazinga we-creatine. I-eGFR isetshenziselwa ukuthola ukuthi izinso zakho zisebenza kahle kangakanani ekuhluzeni imfucuza.

I-eGFR efanelekile ingaphezulu kuka-90, kuyilapho isigaba sesi-5 i-CKD siziveza nge-eGFR engaphansi kuka-15. Ngakho uma i-eGFR yakho iphakama, umsebenzi wakho wezinso olinganiselwayo ungcono kakhulu.

Isigaba 3 i-CKD inezinhlokwana ezimbili ezisuselwa ekufundweni kwe-eGFR. Ungase utholakale unesigaba 3a uma i-eGFR yakho iphakathi kuka-45 no-59. Isigaba 3b sisho ukuthi i-eGFR yakho iphakathi kuka-30 no-44.

Umgomo onesigaba 3 CKD ukuvimbela okunye ukusebenza kwezinso. Ngamagama emitholampilo, lokhu kungasho ukuvimbela i-eGFR ephakathi kuka-29 no-15, okukhombisa isigaba 4 CKD.

Isigaba 3 izimpawu zesifo sezinso

Ungahle ungaziboni izimpawu zezinkinga zezinso ezingamahlalakhona ezigabeni 1 no 2, kodwa izimpawu ziqala ukubonakala kakhulu esigabeni 3.

Ezinye zezimpawu zesigaba 3 se-CKD zingafaka:

• umchamo omnyama ophuzi, owolintshi noma obomvu
• ukuchama kaningi noma kancane kunokujwayelekile
• i-edema (ukugcinwa koketshezi)
• ukukhathala okungachazeki
• ubuthakathaka nezinye izimpawu ezinjenge-anemic
• ukuqwasha nezinye izinkinga zokulala
• ubuhlungu beqolo
• ukwanda komfutho wegazi

Uzoyibona nini udokotela onesigaba 3 CKD

Kubalulekile ukubona udokotela ngokushesha uma uhlangabezana nanoma yiziphi kulezi zimpawu ezingenhla. Ngenkathi izimpawu ezithile zingakhethi i-CKD kuphela, ukuba nenhlanganisela yalezi zimpawu kuphathelene nakho.

Kufanele ulandele udokotela wakho uma uke watholakala ukuthi unesigaba 1 noma isigaba 2 CKD.

Noma kunjalo, kungenzeka ukuthi ungabi nawo umlando wangaphambilini we-CKD ngaphambi kokutholakala unesigaba 3. Lokhu kungabangelwa ukuthi izigaba 1 no-2 akuvamisile ukudala izimpawu ezibonakalayo.

Ukuhlonza isigaba 3 se-CKD, udokotela uzoqhuba lezi zivivinyo:

• ukufundwa kwengcindezi yegazi
• ukuhlolwa komchamo
• Ukuhlolwa kwe-eGFR (kwenziwa njalo ezinsukwini ezingama-90 ngemuva kokuxilongwa kwakho kokuqala)
• ukuhlolwa kwe-imaging ukukhipha i-CKD esezingeni eliphakeme

Ukwelashwa kwesifo sesinso esiteji 3

Isifo sezinso asikwazi ukwelashwa, kepha isigaba 3 sisho ukuthi usenalo ithuba lokuvimbela ukuqhubeka kokuhluleka kwezinso. Ukwelashwa nokuguqulwa kwendlela yokuphila kubalulekile kulesi sigaba. Udokotela wakho uzokhuluma nawe ngokusebenzisa inhlanganisela yezindlela zokwelashwa ezilandelayo.

Isigaba 3 Ukudla kwesifo sezinso

Ukudla okusetshenzisiwe kunzima kakhulu emzimbeni. Njengoba izinso zakho zinesibopho sokukhipha imfucuza nokulinganisa ama-electrolyte, ukudla ukudla okuningi okungalungile kungagcwalisa izinso zakho ngokweqile.

Kubalulekile ukudla kakhulu ukudla okuphelele njengomkhiqizo nezinhlamvu, kanye nokudla ukudla okucutshunguliwe okumbalwa nokuncane kwamafutha agcwele atholakala emikhiqizweni yezilwane.

Udokotela angancoma ukunciphisa amaprotheni owadlayo. Uma amazinga akho e-potassium ephezulu kakhulu kusuka ku-CKD, angaphinde ancoma ukuthi ugweme ukudla okuthile okunepotassium ephezulu njengobhanana, amazambane notamatisi.

Isimiso esifanayo siphathelene ne-sodium. Ungadinga ukunciphisa ukudla okunosawoti uma amazinga akho e-sodium ephezulu kakhulu.

Ukwehla kwesisindo kuvamile ezigabeni ezisezingeni eliphakeme ze-CKD ngenxa yokwehla kwesifiso sokudla. Lokhu futhi kungakubeka engcupheni yokungondleki.

Uma uhlangabezana nokulahlekelwa isifiso sokudla, cabanga ukudla okuncane, ukudla okuvamile njalo usuku lonke ukuze uqiniseke ukuthi uthola ama-calories nezakhi ezanele.

Ukwelashwa

Isigaba 3 i-CKD ayidingi i-dialysis noma ukufakelwa izinso. Esikhundleni salokho, uzonikezwa imithi ethile yokwelapha izimo zezempilo ezingaphansi ezingaba nomthelela ekulimaleni kwezinso.

Lokhu kufaka phakathi ama-angiotensin aguqula i-enzyme (ACE) inhibitors kanye ne-angiotensin II receptor blockers (ARBs) yomfutho wegazi ophakeme, kanye nokuphathwa kweshukela sikashukela.

Udokotela wakho angakunikeza nemithi yokusiza ukunciphisa imiphumela emibi ye-CKD, efana nale:

• izithako zensimbi ze-anemia
• izithako ze-calcium / vithamini D ukuvimbela ukuphuka kwamathambo
• izidakamizwa ezehlisa i-cholesterol
• umchamo wokwelapha i-edema

Ukuphila nesifo sesinso sesigaba 3

Ngaphandle kokuthatha imithi oyinikezwe nokudla ukudla okunempilo, ukwamukela ezinye izinguquko endleleni yakho yokuphila kungakusiza ukuphatha isigaba se-CKD 3. Khuluma nodokotela wakho ngalokhu okulandelayo:

• Ukuzivocavoca umzimba. Hlela okungenani imizuzu engama-30 yomsebenzi olinganiselayo ngosuku ezinsukwini eziningi zeviki. Udokotela angakusiza uqale uhlelo lokuzivocavoca ngokuphepha.
• Ukuphathwa kwengcindezi yegazi. Umfutho wegazi ophakeme ungaba isandulela se-CKD, futhi kungenza isimo sakho sibe sibi kakhulu. Lwela umfutho wegazi ongu-140/90 nangaphansi.

• Ngabe isigaba sesithathu sezinso singabuyiselwa emuva?

  Inhloso yokwelashwa kwesigaba 3 se-CKD ukuvimbela ukuqhubeka okuqhubekayo. Alikho ikhambi lanoma yisiphi isigaba se-CKD, futhi awukwazi ukuguqula ukulimala kwezinso.

  Kodwa-ke, omunye umonakalo usengancishiswa uma usesigabeni 3. Kunzima kakhulu ukuvimbela ukuqhubekela phambili ezigabeni 4 no-5.

  Isigaba 3 sesikhathi sokuphila sesifo sezinso

  Lapho kutholakala ukuthi ilawulwa kusenesikhathi, isigaba sesithathu se-CKD sinesikhathi eside sokuphila kunezigaba ezithuthukile zesifo sezinso. Izilinganiso zingahluka ngokuya ngeminyaka nangendlela yokuphila.

  Okunye ukulinganisela okunjalo kuthi isilinganiso sobude besikhathi sokuphila yiminyaka engama-24 kwabesilisa abaneminyaka engama-40, nama-28 kwabesifazane abalingana neqembu elifanayo.

  Ngaphandle kwesikhathi sonke sokuphila, kubalulekile ukubheka ubungozi bokuqhubeka kwesifo. zesigaba 3 zeziguli ze-CKD zithole ukuthi cishe uhhafu uthuthuke waya ezigabeni ezithuthuke kakhulu zesifo sezinso.

  Kungenzeka futhi ukuhlangabezana nezinkinga ezivela ku-CKD, njengesifo senhliziyo nemithambo yegazi, esingathinta iminyaka yakho yonke yokuphila.

  Ukuthatha

  Isigaba sesi-3 i-CKD ivame ukutholwa okokuqala lapho umuntu eseqale ukuzwa izimpawu zalesi simo.

  Ngenkathi isigaba 3 se-CKD singelapheki, ukuxilongwa kusenesikhathi kungasho ukuyeka ukuqhubeka kwenqubekela phambili. Kungasho futhi nokwehla kwengozi yezinkinga, njengesifo senhliziyo, i-anemia, nokuqhekeka kwamathambo.

  Ukuba nesigaba 3 se-CKD akusho ukuthi isimo sakho sizoqhubekela phambili ngokuzenzakalela ekuhlulekeni kwezinso. Ngokusebenza nodokotela nokuhlala phezu kwezinguquko zendlela yokuphila, kungenzeka ukuvimbela isifo sezinso ukuthi singabi sibi.