Ukwelashwa kanye Nemithi yokwelashwa ye-ADPKD

-Delile

• Imithi
• Ukukhula kwe-cyst yezinso
• Umfutho wegazi ophezulu
• Izifo
• Ubuhlungu
• Ukudla kanye ne-hydration
• Ukuhlinzwa ukwelapha izinkinga
• I-Dialysis noma ukufakelwa kwezinso
• Izindlela zokwelapha ezihambisanayo
• Ukuthatha

Isifo sezinso se-Autosomal esivelele se-polycystic (ADPKD) yisona sifo esivame kakhulu sesifo sezinso se-polycystic (PKD).

Kungadala izinkinga ezahlukahlukene, njenge:

• ubuhlungu
• umfutho wegazi ophakeme
• ukwehluleka kwezinso

Alikho ikhambi le-ADPKD okwamanje. Udokotela wakho angakunika imishanguzo, ushintsho endleleni yokuphila, nokunye ukungenelela ukusiza ukukhulula izimpawu nokuvikela izinkinga.

Funda kabanzi ukuze ufunde kabanzi mayelana nokwelashwa kwe-APDKD.

Imithi

Udokotela wakho angakunikeza imishanguzo eminingi ngokuya ngezimpawu zakho noma ubunzima be-ADPKD.

Ukukhula kwe-cyst yezinso

Ku-2018, i-Food and Drug Administration (i-FDA) ivume umuthi i-tolvaptan (Jynarque) ukwelapha i-ADPKD.

Lo muthi usiza ukunciphisa ukukhula kwama-cysts okwenzeka nge-ADPKD. Lokhu kusiza ukunciphisa ukulimala kwezinso futhi kunciphise ubungozi bokuhluleka kwezinso.

Kukhona ingozi yokulimala kwesibindi noma ukuxhumana kwezidakamizwa lapho uthatha i-tolvaptan. Sebenza nodokotela ogxile kwezempilo yezinso ngomphumela omuhle kakhulu.

I-Tolvaptan ingasetshenziswa kuphela kubantu abadala abane:

• isigaba sesibili noma sesi-3 sesifo sezinso esingalapheki ekuqaleni kokwelashwa
• ubufakazi bokuqhubeka kwesifo sezinso

Imiphumela emibi ejwayelekile ye-tolvaptan (Jynarque) ifaka phakathi:

• ukungaboni kahle
• ukuphefumula kanzima noma ukuphefumula kanzima
• umlomo owomile noma isikhumba esomile
• ukuchama kaningi
• iphunga lokuphefumula elifana nezithelo
• ukwanda kwendlala noma ukoma
• ukwanda kokuchama noma umthamo womchamo ohlanjululwe
• isicanucanu, ukuhlanza, noma ubuhlungu besisu
• ukujuluka
• ukuncipha kwesisindo okungaqondakali
• ubuthakathaka noma ukukhathala okungajwayelekile

Umfutho wegazi ophezulu

Umfutho wegazi ophakeme ungaba nomthelela ekuqhubekeni kwesifo.

Udokotela wakho angancoma ushintsho lwendlela yokuphila kanye nemithi engaba yimithi efana ne-angiotensin-converting enzyme (ACE) inhibitors noma i-angiotensin II receptor blockers (ARBs) ukusiza ukuphatha umfutho wegazi.

Izifo

Ukutheleleka nge-Urinary tract (UTIs), njenge-bladder noma izifo zezinso, ezihlobene ne-ADPKD zingelashwa ngama-antibiotic. Inkambo ende yokwelashwa ingadingeka uma ukutheleleka kuyinkimbinkimbi kunokutheleleka okulula kwesinye.

Ubuhlungu

Imithi yokwelapha efana ne-acetaminophen ingasiza ekudambiseni noma yibuphi ubuhlungu obuhambisana ne:

• ama-cysts ezinso
• izifo
• amatshe ezinso

Izidakamizwa ezingezona ukuvuvukala (ama-NSAID), njenge-ibuprofen, ngokuvamile azinconywa ngenxa yekhono labo lokuphazamisa imithi yengcindezi yegazi nokusebenza kwezinso.

Imithi elwa nokuquleka nayo ingasetshenziswa ukusiza ekunciphiseni ubuhlungu obubangelwa ukulimala kwezinzwa. Lokhu kufaka phakathi i-pregabalin (i-Lyrica) ne-gabapentin (i-Neurontin).

Uma ubuhlungu bungalawulwa ngalezi zindlela, udokotela wakho angacabanga ukunquma eminye imithi yezinhlungu efana nama-opioid. Ama-opioid anemiphumela engemihle eyingqayizivele namandla okuncika, ngakho-ke sebenza nodokotela wakho ukuthola isilinganiso esiphansi kunazo zonke esidingekayo ukusiza ukuphatha ubuhlungu bakho.

Hlala ukhuluma nodokotela wakho ngaphambi kokuthatha uhlobo olusha lwemithi, kufaka phakathi ukudambisa izinhlungu okuthengwa ekhawunteni. Okunye ukudambisa izinhlungu neminye imithi kungalimaza izinso zakho.

Ukudla kanye ne-hydration

Okudlayo kungaba nemiphumela ebalulekile empilweni yakho yezinso, kanye nomfutho wegazi. Ukuhlala kahle u-hydrated kwenza umehluko, futhi, futhi kungasiza ekudluliseni amatshe ezinso nokuvimbela ama-UTIs.

Ukukusiza ukuthi uhlakulele imikhuba yokudla ehlangabezana nezidingo zakho zezempilo, udokotela wakho angakudlulisela kuchwepheshe wezokudla. Bangakusiza ukuthi ufunde ukuthi ikuphi ukudla okufanele kukufake kuhlelo lwakho lokudla nokuthi yikuphi okumele ukhawule noma ukugweme.

Isibonelo, bangakukhuthaza ukuthi:

• nciphisa usawoti, noma i-sodium, ekudleni kwakho ngangokunokwenzeka ukusiza ukunciphisa umfutho wegazi
• udle izingxenye ezincane zeprotheni esezingeni eliphakeme ukuvikela izinso zakho
• nciphisa ukusetshenziswa kwakho kwamafutha asetshenzisiwe nagcwele kakhulu ngangokunokwenzeka ngempilo yenhliziyo
• gwema ukudla kakhulu i-potassium noma i-phosphorus
• Nciphisa ukuthi uphuza kangakanani utshwala

Kubalulekile futhi ukuphuza uketshezi olwanele ukuze uhlale unamanzi amaningi. Abaphenyi njengamanje bafunda ukuthi i-hydration isithinta kanjani isimo.

Ukuhlinzwa ukwelapha izinkinga

Uma uthuthukisa izinkinga ze-ADPKD, udokotela wakho angancoma ukuhlinzwa njengengxenye yohlelo lwakho lokwelashwa.

Isibonelo, bangahle bakunikeze ukuhlinzwa uma uhlakulela:

• ama-cysts ezinso zakho noma ezinye izitho ezibanga ubuhlungu obukhulu obungaphathwa ngemithi
• i-diverticulitis enamandla noma ephindaphindwayo, engathinta udonga lwekholoni yakho
• i-aneurysm yobuchopho, engathinta imithambo yegazi ebuchosheni bakho

Izinhlobo zezinketho zokuhlinza ze-ADPKD zifaka:

• Ukuhlinzwa kwe-cyst drainage. Ama-cysts athelelekile angaphenduli ekwelashweni kwama-antibiotic angakhishwa uketshezi ngenaliti.
• Ukuhlinzwa okuvulwa noma okuqondiswa nge-fiberoptic. Lokhu kungakhipha izindonga zangaphandle zama-cysts ukudambisa izinhlungu.
• Ukususwa kwezinso (nephrectomy). Ukususwa kwengxenye noma zonke izinso kungaba yindlela eyeqisayo kuma-cysts angenakuncipha noma asuswe ngezinye izindlela.
• Ukususwa okuncane kwesibindi (i-hepatectomy) noma ukufakelwa kabusha. Ngokwandiswa kwesibindi noma ezinye izinkinga zesibindi ezihlobene, kunganconywa ukususwa kwesibindi noma ukufakelwa kwesibindi.

Ukuhlinzwa kungasiza ekunciphiseni izinkinga ezithile zalesi simo. Kodwa-ke, ngeke kubambezele ukuthuthukiswa okuphelele kwe-ADPKD.

I-Dialysis noma ukufakelwa kwezinso

Izinso zakho zenza umsebenzi obalulekile ngokuhlunga imfucuza kanye namanzi amaningi egazini lakho.

Uma uba nokuhluleka kwezinso, uzodinga i-dialysis noma ukufakelwa izinso ukuze uphile.

Kunezinhlobo ezimbili eziyinhloko ze-dialysis:

• ukuhlolwa kwe-hemodialysis
• i-peritoneal dialysis

Ku-hemodialysis, umshini wangaphandle usetshenziselwa ukuhlunga igazi lakho ngaphandle komzimba wakho. Ku-peritoneal dialysis, indawo yakho yesisu igcwele nge-dialysate (dialyzing fluid) ukuhlunga igazi lakho emzimbeni wakho.

Uma uthola ukufakelwa izinso, udokotela ohlinzayo uzotshala izinso ezinikelayo ezinempilo kusuka komunye umuntu ziye emzimbeni wakho. Kungathatha iminyaka ukuthola umentshisi omuhle wezinso.

Izindlela zokwelapha ezihambisanayo

Ezinye izindlela zokwelashwa ezihambisanayo zingasiza ukunciphisa izingcindezi zakho noma amazinga obuhlungu. Lokhu kungasiza ukunciphisa umfutho wegazi lakho futhi kuthuthukise impilo engcono ne-ADPKD.

Imisebenzi engasiza ekucindezelekeni noma ekuphathweni kobuhlungu ifaka:

• ukubhucungwa umzimba
• ukutshopa
• ukuzindla
• i-yoga
• tai chi

Ukuzijwayeza indlela yokuphila enempilo nakho kubalulekile ekusizeni ukuphatha umfutho wegazi lakho nokukhuthaza impilo enhle yezinso. Isibonelo, zama uku:

• lala ngokwanele
• zivocavoca njalo
• gwema ukubhema

Hlala ukhuluma nodokotela wakho ngaphambi kokuzama ukwelashwa okuhambisanayo okusha noma wenze izinguquko ezinkulu endleleni yakho yokuphila. Bangakusiza ufunde ukuthi ukwelashwa noma izinguquko ziphephile yini kuwe.

Ungalokothi uthathe amakhambi noma izithako zamavithamini ngaphandle kokukhuluma nodokotela wakho ukuze ufunde ukuthi ziphephile yini. Imikhiqizo eminingi yamakhambi nezithako zamavithamini zingalimaza izinso zakho.

Ukuthatha

Yize i-ADPKD okwamanje ingenakho ukwelashwa, udokotela wakho angancoma imishanguzo, izindlela zokwelashwa, amasu okuphila, futhi kwezinye izimo, ukuhlinzwa ukusiza ukuphatha isimo.

Yazisa udokotela wakho uma uba nezimpawu ezintsha noma ezinye izinguquko empilweni yakho. Bangancoma ukulungiswa kohlelo lwakho lokwelashwa.

Khuluma nodokotela wakho ukuze ufunde kabanzi mayelana nezinzuzo ezingaba khona, ubungozi, nezindleko zezinketho zokwelashwa ezihlukile.