Chipatala Chabwino Kwambiri cha Nephrology ku India | Chipatala Chapamwamba Chosamalira Impso - Zipatala za Apollo

Kulephera kwa impso, komwe kumadziwikanso kuti kuvulala kwa impso (AKI), ndikuchepa kwadzidzidzi kwa impso zomwe zimachitika mkati mwa sabata. Zimachitika pamene impso sizithanso kusefa zonyansa kuchokera m'magazi, kapena kusanja madzi ndi ma electrolyte. 

Zomwe zimayambitsa zimaphatikizapo matenda aakulu, opaleshoni yaikulu, kapena mankhwala ena. 
AKI imayambitsa kuwonongeka kwa impso kapena kulephera m'kanthawi kochepa. AKI ingawonongenso ziwalo zina, monga mtima, mapapo, ndi ubongo. Zikavuta kwambiri, dialysis yochepa ingafunike. AKI ikhoza kusinthidwa ngati itagwidwa msanga koma ikhoza kuyambitsa matenda a impso osachiritsika ngati sanathetsedwe msanga.

Zizindikiro:

• Kuchepa kwa mkodzo
• Kusungidwa kwamadzimadzi kumayambitsa kutupa kwa miyendo, akakolo, kapena mapazi
• Kupuma pang'ono
• kutopa
• chisokonezo
• nseru
• Kupweteka pachifuwa kapena kupanikizika
• Kukomoka muzovuta kwambiri

Njira Zowunika:

• Kuyeza magazi kuyeza creatinine ndi magazi urea nitrogen (BUN)
• Kuwunika kutulutsa kwa mkodzo
• Urinalysis kuti muwone magazi kapena ma cell achilendo
• Kujambula zithunzi monga ultrasound kuti muwone ngati pali vuto
• Impso biopsy nthawi zina

Njira Zochizira:

• Kuchiza zomwe zimayambitsa (mwachitsanzo, sepsis, kuchepa madzi m'thupi)
• Kuyimitsa mankhwala omwe angayambitse kuwonongeka kwa impso
• Mtsempha wamadzimadzi kuti mukhale ndi hydration yoyenera
• Mankhwala oletsa kuchuluka kwa potaziyamu m'magazi
• Dialysis pazovuta kwambiri

Chisamaliro Chotsatira:

• Kuwunika pafupipafupi ntchito ya impso mwa kuyezetsa magazi
• Kutsatira ndi nephrologist, makamaka ngati impso sizigwira ntchito bwino
• Kuyang'anira chitukuko cha matenda aakulu a impso
• Kupewa mankhwala a nephrotoxic
• Maphunziro osamalira thanzi la impso

Chithandizo cha AKI chimadalira chomwe chinayambitsa ndipo cholinga chake ndi kubwezeretsa impso kugwira ntchito bwino. Kuchiza kungaphatikizepo kuchepetsa madzi ndi zakudya, mankhwala, kapena dialysis.

 Werengani kuti mudziwe zambiri 

Matenda a Impso Osatha ndi matenda omwe amadziwika ndi kuwonongeka kwa impso pang'onopang'ono pakapita nthawi. Nthawi zambiri chifukwa cha matenda a shuga kapena kuthamanga kwa magazi, CKD imatha kuyambitsa zovuta monga kuchepa kwa magazi m'thupi komanso matenda amtima. Kumayambiriro kwa CKD sikungakhale ndi zizindikiro kapena zizindikiro zochepa, koma pamene vutoli likuipiraipira, zizindikiro zimatha kukhala zovuta kwambiri.

Zoyambitsa matenda aakulu impso

Kutayika kwapang'onopang'ono kwa impso kumachitika chifukwa cha zinthu zomwe zimachitika nthawi yayitali, monga:

• shuga
• Kuthamanga kwa magazi
• Kutupa mu impso
• Matenda a impso a Polycystic
• Matenda osokoneza bongo
• Zofooka zomwe zimapezeka pakubadwa
• Kugwiritsa ntchito nthawi yayitali mankhwala ena, monga NSAIDs
• Kukumana ndi poizoni, monga poyizoni wa mtovu 

Zizindikiro:

• kutopa
• Kutupa miyendo ndi akakolo
• Kusintha kwa machitidwe a mkodzo
• Kuthamanga kwa magazi
• Anemia
• Njala yosauka
• nseru
• Vuto likuyang'ana
• Dzanzi m'manja kapena mapazi

Njira Zowunika:

• Kuyeza magazi kuyeza urea, creatinine ndikuwerengera kuchuluka kwa kusefera kwa glomerular (eGFR)
• Mayeso a mkodzo kuti awone mapuloteni (albumin) ndikuwerengera mkodzo wa albumin-to-creatinine ratio (UACR)
• Mayeso oyerekeza ngati ultrasound kapena CT scan kuti awone mawonekedwe a impso
• Impso biopsy nthawi zina

Njira Zochizira:

• Mankhwala oletsa kudwala matenda a shuga komanso kuthamanga kwa magazi
• ACE inhibitors kapena ARBs kuteteza impso ntchito
• Kusintha kwazakudya kumachepetsa kudya kwa sodium, potaziyamu, ndi phosphorous
• Chithandizo cha kuchepa kwa magazi m'thupi, ngati chilipo
• Pakupita patsogolo, dialysis kapena kumuika impso

Chisamaliro Chotsatira:

• Kuwunika pafupipafupi ntchito ya impso kudzera m'magazi ndi mkodzo
• Kuyeza kuthamanga kwa magazi
• Kusintha kwamankhwala ngati pakufunika
• Kutumiza kwa nephrologist
• Maphunziro okhudza kusintha kwa moyo ndi zakudya

Werengani kuti mudziwe zambiri za CKD

Impso ndi miyala yolimba ya mchere ndi mchere mkati mwa impso. Amatha kuchoka ku timbewu tating'ono mpaka miyala ikuluikulu. Nthawi zambiri miyala ya impso imatuluka m'thupi pokodza. Kudutsa miyala ya impso kumatha kukhala kowawa kwambiri, koma sikumayambitsa mavuto akulu.

Zizindikiro:

• Kupweteka kwakukulu m'mbali, msana, m'munsi pamimba, kapena groin
• Ululu womwe umabwera m'mafunde ndikusinthasintha mwamphamvu
• Mkodzo wa pinki, wofiira, kapena wabulauni
• Wodzaza kapena mkodzo wonunkha
• Mseru ndi kusanza
• Kuthamanga mobwerezabwereza
• Kukodza pang'ono

Njira Zowunika:

• Urinalysis kuti muwone magazi ndi makristasi
• Kuyeza magazi kuti awone ntchito ya impso ndikuyang'ana kuchuluka kwa calcium kapena uric acid
• Kujambula zithunzi monga CT scan, ultrasound, kapena X-ray kuti muwone miyala

Njira Zochizira:

• Kusamalira ululu ndi mankhwala olembedwa
• Kuchulukitsa kwamadzimadzi kuti muchepetse miyala yaying'ono
• Chithandizo chochotsa mankhwala pogwiritsa ntchito alpha-blockers
• Extracorporeal shock wave lithotripsy (ESWL) kuti athyole miyala yayikulu
• Ureteroscopy kuchotsa kapena kuswa miyala
• Percutaneous nephrolithotomy kwa miyala ikuluikulu

Chisamaliro Chotsatira:

• Kujambula kotsatira kuonetsetsa kuti miyala yonse yadutsa
• Kusonkhanitsa mkodzo wa maola 24 kuti mudziwe zoopsa zomwe zingapangidwe mwala
• Kusintha kwa zakudya kutengera kapangidwe ka miyala
• Kuchuluka kwa madzimadzi kuti mupewe kuyambiranso
• Mankhwala oletsa mapangidwe a miyala mwa anthu omwe ali pachiopsezo chachikulu

Glomerulonephritis ndi kutupa kwa mayunitsi osefa a impso (glomeruli). Glomeruli ndi kagawo kakang'ono kwambiri kosefera mkati mwa impso zomwe zimasefa magazi. Glomerulonephritis imatha kuyambitsidwa ndi matenda, mankhwala, kapena zovuta zomwe zimachitika panthawi yobadwa kapena atangobadwa kumene (zobadwa nazo). Nthawi zambiri zimakhala bwino zokha. Mitundu ina imayankha bwino chithandizo, pamene ina imatha kupita ku matenda aakulu a impso. Kuyang'anitsitsa nthawi zonse ndikofunikira kuti muthe kuyendetsa bwino vutoli.

Zizindikiro:

• Magazi mumkodzo (hematuria)
• Mkodzo wa thovu chifukwa cha mapuloteni ochulukirapo (proteinuria)
• Kuthamanga kwa magazi
• Kuchuluka kwa madzi kumayambitsa kutupa (edema)
• kutopa
• Kuchepa kwa mkodzo muzovuta kwambiri

Njira Zowunika:

• Urinalysis kuti muwone magazi ndi mapuloteni
• Kuyeza magazi kuti awone ntchito ya impso ndikuyang'ana zizindikiro za kutupa
• Maphunziro oyerekeza ngati ultrasound kuti awone kukula kwa impso ndi kapangidwe kake
• Impso biopsy kudziwa mtundu weniweni wa glomerulonephritis

Njira Zochizira:

• Corticosteroids kuti muchepetse kutupa
• Mankhwala a Immunosuppressive nthawi zina
• Mankhwala a kuthamanga kwa magazi, makamaka ACE inhibitors kapena ARBs
• Ma diuretics kuti muchepetse kusungidwa kwamadzi
• Chithandizo cha zinthu zomwe zayamba (mwachitsanzo, matenda, matenda a autoimmune)

Chisamaliro Chotsatira:

• Kuwunika pafupipafupi ntchito ya impso ndi kuchuluka kwa mapuloteni amkodzo
• Kuwongolera kuthamanga kwa magazi
• Kusintha kwamankhwala ngati pakufunika
• Kuwunika zotsatira za mankhwala a immunosuppressive
• Kusintha zakudya, monga kuchepetsa kudya mchere

Matenda a impso a Polycystic ndi vuto la majini lomwe limapangitsa kuti ma cysts (matumba ang'onoang'ono amadzimadzi) akule mu impso. Ma cysts awa amatha kusokoneza ntchito ya impso ndikuyambitsa kulephera kwa impso. Zitha kupangitsa kuti impso zikule komanso kusagwira bwino ntchito pakapita nthawi. Ndikofunikira kudziwa kuti zotupa za impso pawokha ndizofala kwambiri ndipo nthawi zonse zimakhala zopanda vuto. Matenda a impso a polycystic ndi matenda oopsa kwambiri. Pamene matendawa akupita patsogolo, dialysis kapena kuika impso kungakhale kofunikira.

Zizindikiro:

• Kuthamanga kwa magazi
• Kupweteka kumbuyo kapena mbali
• Magazi mumkodzo
• Impso miyala
• Mimba yokulitsa
• litsipa
• Matenda a m'magulu a urinary

Njira Zowunika:

• Maphunziro oyerekeza monga ultrasound, CT scan, kapena MRI kuti muwone ma cysts a impso
• Kuyesa kwa ma genetic kuti atsimikizire kuti ali ndi matenda ndi kudziwa mtundu wa PKD
• Kuyeza magazi kuti awone ntchito ya impso
• Urinalysis kuti muwone magazi kapena mapuloteni mumkodzo

Njira Zochizira:

• Kuwongolera kuthamanga kwa magazi ndi ACE inhibitors kapena ARBs
• kasamalidwe ululu
• Chithandizo cha matenda a mkodzo
• Tolvaptan kuti achepetse kukula kwa cyst mwa odwala ena
• Dialysis kapena kuika impso mu magawo apamwamba

Chisamaliro Chotsatira:

• Kuwunika pafupipafupi ntchito ya impso ndi kukula kwa chotupa
• Kuwongolera kuthamanga kwa magazi
• Kuwunika kwa zovuta monga aneurysms
• Uphungu wa majini kwa achibale
• Kusintha kwa moyo, kuphatikizapo zakudya zopanda mchere komanso madzi okwanira

Matenda a impso, omwe amadziwikanso kuti pyelonephritis, ndi mtundu wa matenda a mkodzo (UTI) omwe amapezeka pamene mabakiteriya, ndipo nthawi zina bowa kapena mavairasi, akhudza impso imodzi kapena zonse ziwiri. Vutoli likhoza kukhala lalikulu ndipo lingafunike chithandizo chamankhwala mwamsanga, makamaka ngati lifalikira m’magazi.

Zimayambitsa:

Matenda: Nthawi zambiri amayamba chifukwa cha Escherichia coli (E. coli), yomwe imayambira m'mimba ndipo imadutsa m'mikodzo.

Kufalikira kuchokera ku Lower UTIs: Nthawi zambiri imayamba ngati matenda a chikhodzodzo (cystitis) ndikupita ku impso.

Kutsekeka Kapena Kutsekereza: Miyala ya impso, kukula kwa prostate, kapena zopinga zina m’njira ya mkodzo zingawonjezere ngoziyo.

Ma Catheters kapena Zida Zachipatala: Zimachulukitsa mwayi wotenga matenda.

Kufooka kwa Chitetezo cha mthupi: Mikhalidwe monga matenda a shuga, kapena kugwiritsa ntchito mankhwala oletsa chitetezo chamthupi, kungayambitse kutengeka.

Zizindikiro:

Kutentha kwakukulu ndi kuzizira.

Kupweteka kumbuyo, mbali (mbali), kapena pansi pamimba.

Kukodza pafupipafupi kapena kowawa (dysuria).

Mkodzo wamtambo, wonunkha, kapena wamagazi.

Nseru kapena kusanza.

Kutopa kapena malaise.

Okalamba amatha kusokonezeka kapena kusintha maganizo m'malo mwa zizindikiro zodziwika bwino.

Azimayi amatha kukhala ndi vuto laufupi la mkodzo, zomwe zimapangitsa kuti mabakiteriya azifika pachikhodzodzo ndi impso mosavuta.Mimba imayambitsa kusintha kwa mahomoni ndi matupi awo omwe amawonjezera chiopsezo.Zolepheretsa monga Miyala, zotupa, kapena zolakwika za anatomical zimapangitsa kuti pakhale ngozi.

Mavuto:

Sepsis: Matenda oika moyo pachiswe ngati matendawa afalikira m’magazi.

Kutupa kwa Impso: Matumba a mafinya amatha kupanga mkati kapena kuzungulira impso.

Matenda a Impso (CKD): Matenda okhalitsa kapena obwerezabwereza angayambitse zipsera ndi kuwonongeka kwa nthawi yaitali.

Zovuta za Pakati pa Pakati: Zingayambitse kubereka mwana asanakwane kapena kulemera kochepa ngati sikunalandire chithandizo.

Njira Zowunika:

• Urinalysis kuti muwone mabakiteriya ndi maselo oyera a magazi
• Chikhalidwe cha mkodzo kuti mudziwe mabakiteriya omwe amayambitsa matendawa
• Kujambula zithunzi monga CT kapena ultrasound ngati matenda obwerezabwereza achitika

Njira Zochizira:

• Maantibayotiki opangidwa ndi mabakiteriya enieni
• Zothetsa ululu chifukwa cha kusapeza bwino
• Kuchuluka kwa madzimadzi kuti athandize kuchotsa mabakiteriya
• Mu zinachitikira otsika mlingo mankhwala kupewa

Chisamaliro Chotsatira:

• Kumaliza maphunziro operekedwa ndi maantibayotiki
• Kuwunikanso mkodzo kuwonetsetsa kuti matendawa atha
• Kusintha kwa moyo kuti mupewe kuyambiranso (mwachitsanzo, ukhondo, kukhala wopanda madzi)
• Kufufuza zomwe zimayambitsa zochitika zomwe zimachitika kawirikawiri
   

Khansara ya impso ndi kukula kwachilendo kwa maselo a impso. Zimachitika pamene maselo a impso amakula osalamulirika, ndikupanga chotupa. Zimapezeka kwambiri mwa anthu opitilira zaka 65 ndipo zimatha kukhudza amuna kuwirikiza kawiri kuposa akazi.

Zizindikiro:

• Magazi mumkodzo (hematuria)
• Kupweteka kosalekeza m'mbali kapena m'munsi
• Kutaya kosawerengeka kosadziwika
• kutopa
• Kutentha kosayamba chifukwa cha matenda
• Kuthamanga kwa magazi komwe kumakhala kovuta kuwongolera

Njira Zowunika:

• Kuwunika kwakuthupi komanso mbiri yakale yachipatala
• Kuyeza magazi ndi mkodzo kuti awone ntchito ya impso
• Kujambula zithunzi monga CT scans, MRI, kapena ultrasound
• Impso biopsy nthawi zina kutsimikizira matenda

Njira Zochizira:

• Kuchita Opaleshoni (kanthawi kochepa kapena kopitilira muyeso nephrectomy)
• Chithandizo cha ablation cha zotupa zazing'ono
• Njira zochizira mankhwala osokoneza bongo
• immunotherapy
• Chithandizo cha radiation nthawi zina

Chisamaliro Chotsatira:

• Kujambula kwanthawi zonse kuti muwunikire kubwereza
• Kuyeza magazi kuti awone ntchito ya impso
• Kuwongolera zotsatira zoyipa kuchokera kumankhwala
• Kusintha kwa moyo kuti muchepetse zoopsa

Werengani kuti mudziwe zambiri za Khansa ya Impso

1. Mayeso a Impso (KFTs): Mayeso a Impso Ntchito ndi gulu la mayeso a magazi ndi mkodzo omwe amayesa momwe impso zanu zikuyendera bwino. Mayeserowa ndi ofunikira kuti muzindikire zovuta za impso koyambirira ndikuwunika momwe matenda a impso akupitira. Izi zikuphatikizapo:
 

Mayeso a Magazi a Urea Nitrogen (BUN).: Mayeso a Blood Urea Nitrogen (BUN) ndi chida chofunikira kwambiri chowunikira ntchito ya impso. Mayesowa amayesa kuchuluka kwa urea m'magazi anu, zomwe ndi zonyansa zomwe nthawi zambiri zimasefedwa ndi impso zathanzi. Ntchito ya impso ikachepa, kuchuluka kwa BUN m'magazi kumakwera.

Werengani zambiri

 Mayeso a Serum Creatinine: Mayeso a Serum Creatinine ndi chida chofunikira chowunikira chomwe chimagwiritsidwa ntchito poyesa ntchito ya impso. Creatinine ndi zonyansa zomwe zimapangidwa ndi kagayidwe ka minofu ndipo nthawi zambiri zimasefedwa m'magazi ndi impso. Impso zikayamba kugwira ntchito, kuchuluka kwa creatinine m'magazi kumawonjezeka.

Werengani zambiri

Glomerular Filtration Rate (GFR): Kuwerengera kwa Glomerular Filtration Rate (GFR) ndi chida chofunikira kwambiri powunika ntchito ya impso zonse. Amapereka chiŵerengero cha kuchuluka kwa magazi omwe amadutsa mu glomeruli (zosefera zing'onozing'ono za impso) mphindi iliyonse, zomwe zimapereka chidziwitso chokwanira cha thanzi la impso. GFR imawerengedwa pogwiritsa ntchito mulingo wa serum creatinine, zaka, jenda, ndi zinthu zina kuti muyerekeze ntchito ya impso.

Werengani zambiri

Creatinine Clearance Test: Imayezera momwe impso zimayeretsera creatinine m'magazi mkati mwa maola 24. Pamafunika zonse magazi ndi mkodzo zitsanzo. Chilolezo chochepa chimasonyeza kusefera kwa impso.

Werengani zambiri

Miyezo ya Electrolyte: Kuyeza ma electrolyte ofunikira monga sodium, potaziyamu, chloride, ndi bicarbonate. Kusalinganika kungasonyeze kusagwira ntchito kwa impso, chifukwa impso zimayendetsa ma electrolyte.

Werengani zambiri

Kusanthula mkodzo: Urinalysis ndi mayeso angapo omwe amachitidwa pachitsanzo cha mkodzo kuti azindikire zovuta zosiyanasiyana za impso ndi mkodzo. Mayesowa amatha kuzindikira zinthu zosiyanasiyana, kuyambira matenda a mkodzo mpaka matenda a impso.

Zomwe Mayeso Awa Akuwonetsa:

• Mapuloteni mu Mkodzo: Angasonyeze kuwonongeka kwa impso
• Magazi Mumkodzo: Atha kuwonetsa miyala ya impso kapena mavuto ena
• Matenda a mkodzo: Amazindikira kupezeka kwa mabakiteriya kapena maselo oyera a magazi
• Milingo ya Glucose: Itha kuwonetsa matenda a shuga

• Chikhalidwe cha mkodzo ndi kukhudzika kwa mkodzo zimatha kuzindikira zamoyo zomwe zayambitsa matendawa ndikudziwitsa maantibayotiki omwe angayankhe.
  
   

  Zoyenera Kuyembekezera:

• Pamafunika chitsanzo cha mkodzo
• Palibe kukonzekera kwapadera kofunikira
• Zotsatira zimapezeka pakatha tsiku limodzi

1. Renal Ultrasound: Renal ultrasound ndi njira yojambulira yosasokoneza yomwe imagwiritsa ntchito mafunde omveka kwambiri kuti apange zithunzi zatsatanetsatane za impso ndi zozungulira. Njira yotetezeka komanso yosapweteka imeneyi ndi chida chofunikira kwambiri pozindikira ndi kuwunika matenda osiyanasiyana a impso. Ultrasound imagwiritsa ntchito mafunde amawu kupanga zithunzi za impso zanu ndi thirakiti la mkodzo.

Werengani zambiri

2. CT Scan: Kujambula kwa Computerized Tomography (CT), komwe kumadziwikanso kuti CAT scan, ndi njira yapamwamba yojambula yomwe imagwiritsa ntchito ma X-ray ndi kukonza makompyuta kuti apange zithunzi zatsatanetsatane za thupi. Pofufuza matenda a impso, CT scan imapereka zithunzi zambiri za impso, ureters, ndi chikhodzodzo, zomwe zimapangitsa kuti ikhale chida chamtengo wapatali mu nephrology.

Werengani zambiri

3. Kujambula kwa Magnetic Resonance (MRI): Kujambula kwa Magnetic Resonance Imaging (MRI) ndi njira yaukadaulo yojambula yomwe imagwiritsa ntchito maginito amphamvu ndi mafunde a wailesi kupanga zithunzi zatsatanetsatane za mkati mwa thupi. Pofufuza matenda a impso, MRI imapereka zithunzi zowoneka bwino za impso ndi minofu yozungulira popanda kugwiritsa ntchito ma radiation a ionizing.

Werengani zambiri

4. Impso Biopsy: Impso biopsy ndi njira yomwe minofu yaimpso yaing'ono imachotsedwa kuti ifufuze pang'ono. Njira yowunikirayi imapereka chidziwitso chatsatanetsatane chokhudza mapangidwe a impso ndi magwiridwe antchito pama cell, ndikupangitsa kuti ikhale chida chamtengo wapatali mu nephrology.

Werengani zambiri

Apollo Institute of Nephrology imapereka chithandizo chokwanira chachipatala cha nephrology, kupereka chisamaliro cha akatswiri kwa odwala omwe ali ndi matenda osiyanasiyana okhudzana ndi impso. 

1. Kusamalira Matenda Onse a Impso

Gulu lachipatala la nephrology ku Apollo limakhazikika pakuzindikira ndi kuchiza matenda osiyanasiyana a impso, kuphatikiza:

• Kuvulala kwakukulu kwa impso
• Matenda a impso (CKD)
• Glomerulonephritis
• Matenda ashuga nephropathy
• Matenda oopsa a impso
• Matenda a impso a Polycystic
• Lupus nephritis
• Impso miyala

Gululi limagwiritsa ntchito njira zosiyanasiyana, pogwiritsa ntchito zida zowunikira zapamwamba monga ma biopsies a impso ndi njira zapadera zojambulira kuti azindikire molondola komanso kuwonetsa matenda a impso. Mapulani a chithandizo amapangidwa mogwirizana ndi momwe wodwala aliyense alili ndipo sungaphatikizepo kasamalidwe ka mankhwala, kusintha kadyedwe, komanso ngati kuli kofunikira, machiritso obwezeretsa aimpso.

ubwino:

• Kuzindikira msanga ndi kuchitapo kanthu kuti matenda achepe
• Mapulani amunthu payekha malinga ndi zosowa za wodwala aliyense
• Kupeza njira zochiritsira zotsogola komanso mayesero azachipatala
• Chisamaliro chokwanira kuchokera ku gulu la akatswiri

2. Uphungu wa Matenda a Impso

Apollo Institute of Nephrology imatsindika kwambiri za maphunziro a odwala ndi uphungu. Alangizi odzipereka amagwira ntchito limodzi ndi odwala komanso mabanja awo kuti awathandize:

• Tsatanetsatane wa matenda a impso ndi kasamalidwe kawo
• Malangizo pakusintha kwa moyo kuti athandizire thanzi la impso
• Thandizo lamalingaliro ndi njira zothetsera
• Maphunziro okhudza njira zamankhwala ndi zotsatira zake

ubwino:

• Kumvetsetsa bwino kwa odwala ndikutsatira ndondomeko zachipatala
• Kupititsa patsogolo umoyo wa moyo poyendetsa bwino matenda
• Kuchepetsa nkhawa komanso kukhala ndi thanzi labwino m'maganizo
• Kupatsa mphamvu odwala kuti atenge nawo mbali pa chisamaliro chawo

3. Chithandizo cha Associated Conditions

Matenda a impso nthawi zambiri amakhala limodzi kapena amatsogolera ku zovuta zina zaumoyo. Gulu lachipatala la nephrology ku Apollo limapereka chisamaliro chokwanira pamikhalidwe yokhudzana ndi izi, kuphatikiza:

• Kuwongolera kuthamanga kwa magazi
• Kusamalira ndi kupewa matenda a shuga a nephropathy
• Chithandizo cha kuchepa kwa magazi m'thupi
• Matenda a mafupa ndi minerals
• Matenda a mtima
• Kusagwirizana kwa electrolyte

ubwino:

• Chisamaliro chokwanira chokhudza mbali zonse za thanzi la impso
• Kuchepetsa chiopsezo cha zovuta chifukwa chowongolera mwachangu
• Kupititsa patsogolo thanzi labwino komanso moyo wabwino
• Chisamaliro chogwirizana pazapadera zambiri zamilandu yovuta

Apollo Institute of Nephrology imapereka chithandizo chokwanira cha Renal Replacement Therapies (RRT) kwa odwala omwe ali ndi matenda a aimpso omaliza (ESRD) kapena kuvulala koopsa kwa impso. Mankhwala apamwambawa amapangidwa kuti alowe m'malo mwa impso zomwe zimagwira ntchito bwino komanso zosefera ngati sizitha kuchita bwino. Bungweli limapereka zosankha zingapo za RRT kuti zigwirizane ndi zosowa za wodwala aliyense, kuwonetsetsa chisamaliro choyenera komanso moyo wabwino kwa omwe ali ndi vuto la impso.

1. Gawo la Dialysis la maola 24

Apollo's 24-hour Dialysis Unit ndi malo apamwamba kwambiri omwe amapereka chithandizo cha dialysis usana ndi usiku kwa odwala omwe ali ndi vuto lalikulu la impso. Chigawochi chili ndi makina amakono a dialysis ndipo amakhala ndi akatswiri odziwa za matenda a nephrologist, akatswiri a dialysis, ndi anamwino.

zinthu zikuluzikulu:

• Kupezeka kosalekeza kwa zosowa zadzidzidzi za dialysis
• Kusintha kosinthika kuti mukhale ndi moyo wodwala
• Njira zowongolera matenda
• Kuwunika nthawi zonse ndikusintha ndondomeko za chithandizo

ubwino:

• Kupeza mwachangu chithandizo chopulumutsa moyo kuvulala koopsa kwa impso
• Kuchepetsa kugonekedwa m'chipatala kwa odwala dialysis osatha
• Kupititsa patsogolo chitonthozo cha odwala komanso kumasuka
• Kukwanitsa kuthana ndi zovuta zokhudzana ndi dialysis mwachangu
  
   

Mitundu ya dialysis 

1. Hemodialysis

Hemodialysis ndi njira yodziwika bwino ya RRT pomwe magazi amasefedwa kunja kwa thupi pogwiritsa ntchito makina a dialysis. Ntchito ya Apollo hemodialysis imagwiritsa ntchito ukadaulo wapamwamba kupereka chithandizo choyenera komanso chomasuka.

ndondomeko:

• Magazi amatengedwa kuchokera kwa wodwalayo kudzera kumalo ofikira mitsempha
• Magazi amadutsa mu dialyzer (impso yopangira) yomwe imachotsa zinyalala ndi madzi ochulukirapo
• Magazi oyeretsedwawo amabwezedwa m’thupi la wodwalayo

Mawonekedwe:

• Ma dialyzer apamwamba kwambiri ochotsa poizoni
• Ultrapure dialysis madzi machitidwe
• Mankhwala a dialysis payekha
• Kusamalidwa nthawi zonse ndi kuwunika kwa mitsempha ya mitsempha

ubwino:

• Kuchotsa bwino zinthu zonyansa ndi madzi owonjezera
• Kuwongolera bwino kwa kuthamanga kwa magazi ndi kuchepa kwa magazi m'thupi
• Kupititsa patsogolo thanzi labwino komanso moyo wabwino
• Kuchepetsa chiopsezo cha zovuta zokhudzana ndi dialysis

2. Peritoneal Dialysis

Peritoneal Dialysis (PD) ndi njira ya dialysis yochokera kunyumba yomwe imagwiritsa ntchito peritoneum ya wodwala ngati fyuluta yachilengedwe. Apollo amapereka maphunziro athunthu ndi chithandizo kwa odwala omwe akusankha PD.

Mitundu yoperekedwa:

• Continuous Ambulatory Peritoneal Dialysis (CAPD)
• Automated Peritoneal Dialysis (APD)

Zigawo zikuluzikulu:

• Kulembera ndi kuwunika kwa PD
• Mapulogalamu ophunzitsira odwala ndi osamalira
• Kuyendera kunyumba pafupipafupi ndi anamwino a PD
• Thandizo la 24/7 pazinthu zokhudzana ndi PD

ubwino:

• Kudziyimira pawokha kwakukulu komanso kusinthasintha m'moyo watsiku ndi tsiku
• Kusungidwa kwa ntchito yotsalira ya impso
• Kuchepetsa zakudya ndi zoletsa zamadzimadzi poyerekeza ndi hemodialysis
• Chiwopsezo chochepa cha matenda a m'magazi

Werengani zambiri

3. Hemodiafiltration

Hemodiafiltration (HDF) ndi njira yotsogola ya hemodialysis yomwe imaphatikizira kufalitsa ndi kuwongolera mfundo zochotsa zinyalala. Apollo imapereka HDF yapaintaneti, pomwe kusintha komwe kumagwiritsidwa ntchito kumapangidwa munthawi yeniyeni panthawi ya dialysis. 

ndondomeko:

• Amaphatikiza muyezo wa hemodialysis ndi hemofiltration
• Amagwiritsa ntchito ma membranes othamanga kwambiri komanso kusinthana kwamadzimadzi
• Amachotsa poizoni ang'onoang'ono ndi akulu omwe amalemera mamolekyulu

Mawonekedwe:

• Kupanga nthawi yeniyeni yamadzimadzi am'malo a ultrapure
• HDF yapamwamba kwambiri kuti igwire bwino ntchito
• Machitidwe owonetsetsa kuti athandizidwe bwino ndi mankhwala

ubwino:

• Wapamwamba kuchotsa pakati ndi lalikulu maselo kulemera poizoni
• Kukhazikika kwamtima pamtima pamankhwala
• Kuwongolera bwino kwa phosphorous ndi kuchepetsa kufunika kwa mankhwala
• Kuthekera kwa kupulumuka kwanthawi yayitali poyerekeza ndi hemodialysis wamba

Kuika Impso ku Apollo Institute of Nephrology kumayimira golide wochiritsira matenda omaliza aimpso (ESRD). Opaleshoni imeneyi imaphatikizapo kuika impso yathanzi kuchokera kwa wopereka chithandizo kupita kwa wodwala amene ali ndi vuto la impso. Dongosolo la Apollo loti amuike ndi lodziŵika chifukwa cha kuchita bwino kwambiri, kuphatikiza ukatswiri wa opaleshoni ndi chisamaliro chambiri chisanadze ndi pambuyo pa kumuika kuti atsimikizire zotulukapo zabwino kwa odwala.

1. Kusintha kwa Wopereka Wamoyo

Kuika kwa wopereka wamoyo kumaphatikizapo kuyika impso kuchokera kwa wopereka wamoyo, makamaka wachibale wapafupi kapena wodzipereka wogwirizana, kwa wolandirayo.

Mbali zazikulu:

• Kuwunika kwakukulu kwa opereka kuti atsimikizire kuyenerera ndi chitetezo
• Kujambula kwapamwamba kwa minofu ndi kufananiza kuti zigwirizane bwino ndi wopereka ndi wolandira
• Kuchotsa nephrectomy kwa laparoscopic ngati kuli kotheka
• Maphunziro athunthu opereka ndi olandila
• Chisamaliro chotsatira kwa nthawi yayitali kwa onse omwe amapereka ndi wolandira

ubwino:

• Nthawi zodikirira zazifupi poyerekeza ndi kupatsirana kwa cadaveric
• Zabwino zokhala ndi moyo wautali wautali
• Kutha kukonza opaleshoni yomuika pasadakhale
• Mwayi woti munthu ayambe kumuika mumsana usanakhale wofunika dialysis
• Wabwino impso ntchito mwamsanga pambuyo kumuika nthawi zambiri

2. Cadaveric Transplantation

Kuyika kwa cadaveric, komwe kumadziwikanso kuti kufa kwa donor transplantation, kumaphatikizapo kuyika impso kuchokera kwa wopereka yemwe wamwalira posachedwa kupita kwa wolandira pamndandanda wodikirira.

zinthu zikuluzikulu:

• Kugwirizana ndi makomiti aboma ndi maukonde kuti agawidwe moyenera
• Kupezeka kwa gulu la 24/7 kuti mutengenso chiwalo ndi kumuika
• Ndondomeko zowunikira bwino za ziwalo
• Njira zotetezera zapamwamba kuti thupi likhale lolimba
• Kuwunika kokwanira kwa wolandira ndi kukonzekera

ubwino:

• Amapereka chiyembekezo kwa odwala popanda wopereka moyo wabwino
• Amalola dziwe lalikulu la omwe angapereke
• Mwayi kwa odwala omwe ali ndi minofu yosowa kuti apeze machesi
• Zimathandizira kuzinthu zambiri zopereka zida zamoyo
• Zitha kubweretsa zotulukapo zopambana zofananira ndi ma transplants okhala ndi kasamalidwe koyenera

Chisamaliro cha pambuyo pa kumuika ku Apollo chimaphatikizapo:

• Makhalidwe a immunosuppression regimens
• Kuyang'anira ndi kuyang'anira nthawi zonse
• Maphunziro athunthu a odwala pa kutsata mankhwala komanso kusintha kwa moyo
• Kuwongolera mwachangu zovuta zilizonse kapena magawo okana

Apollo Institute of Nephrology imapereka njira zingapo zopititsira patsogolo zowunikira ndikuchiza matenda osiyanasiyana a impso. Njira zowononga pang'ono izi zimalola kuti munthu azindikire molondola, kuwongolera bwino kwa chithandizo, komanso kuchepetsa nthawi yochira poyerekeza ndi maopaleshoni apakale. 

1. Impso Biopsy

Impso biopsies ndi njira zodziwira zomwe zimagwiritsidwa ntchito kupeza timitu tating'ono ta impso kuti tifufuze mozama kwambiri. Njira imeneyi ndi yofunika kwambiri kuti munthu adziwe bwinobwino matenda a impso komanso pokonzekera chithandizo cha matenda osiyanasiyana a impso.

Werengani zambiri za Impso Biopsies

2. Kufikira kwa Mitsempha Yaitali

Kukhazikitsa ndi kusunga mwayi wofikira kwa nthawi yayitali ndikofunikira kwa odwala omwe amafunikira hemodialysis nthawi zonse. Gulu la Apollo interventional nephrology limakhazikika pakupanga ndi kuyang'anira mitundu yosiyanasiyana ya mitsempha.

Mitundu yofikira:

• Arteriovenous (AV) fistulas
• Zithunzi za AV
• Catheters yapakati

Njira zoperekedwa:

Kufikira kwa Vascular

Kufika kwa mitsempha kumatanthauza kupanga kulumikizana pakati pa mitsempha yamagazi ya hemodialysis kapena chithandizo china chamankhwala. Mitundu iwiri yodziwika bwino yofikira mitsempha imatchulidwa:

1.Arteriovenous (AV) Grafts:

Chubu chopangidwa ndi opaleshoni chimayikidwa kuti chilumikizane ndi mtsempha ndi mtsempha. Amagwiritsidwa ntchito pamene mitsempha ya wodwala siili yoyenera kwa arteriovenous fistula (AV fistula) .Imapereka mwayi wodalirika wa dialysis.

2. Central Venous Catheters:

Katheta yosakhalitsa kapena yokhazikika yomwe imayikidwa mumtsempha waukulu (mwachitsanzo, khosi, chifuwa, kapena groin). Amagwiritsidwa ntchito kuti apeze dialysis mwamsanga kapena kwakanthawi kochepa pamene njira zina sizikupezeka.

Njira Zoperekedwa:

1.Fistula kapena Graft Creation Surgery:

AV Fistula: Imalumikiza mwachindunji mtsempha wamagazi ndi mtsempha, kupereka mwayi wanthawi yayitali wa hemodialysis.

AV Graft: Imagwiritsa ntchito chubu chopangira kupanga kulumikizana kwa odwala omwe ali ndi mitsempha yosayenera.

2. Angioplasty kwa Stenosis:

Njira yochepetsera pang'ono yokulitsa mitsempha yopapatiza. Imabwezeretsa kutuluka kwa magazi mu fistula yopapatiza ya AV kapena kumezanitsa.

3. Thrombectomy for Clotted Access:

Kuchotsa magazi omwe amatsekereza malo ofikira mitsempha. Imawonetsetsa kupitiliza kugwiritsa ntchito mwayi wa dialysis.

Kuyika kwa 4.Stent kwa Recurrent Stenosis:

Stent (kachubu kakang'ono ka mesh) amayikidwa mumtsempha wamagazi kuti usatseguke. Amagwiritsidwa ntchito pazochitika zomwe kuchepetsa (stenosis) kumabwereza ngakhale angioplasty.

3. Renal Angioplasty ndi Stenting

Renal angioplasty ndi stenting ndi njira zomwe zimagwiritsidwa ntchito pochiza aimpso stenosis, mkhalidwe womwe mitsempha yopereka magazi ku impso imachepa.

4. Kuyika kwa Permaath

Kuyika kwa Permaath kumaphatikizapo kuika katheta yapakati ya venous kuti athe kupeza hemodialysis kwa nthawi yayitali, makamaka kwa odwala omwe akudikirira kukhwima kwa fistula kapena omwe sali oyenerera ku mitundu ina.

Critical Care Nephrology ku Apollo Institute of Nephrology imapereka chisamaliro chapadera kwa odwala omwe ali ndi vuto lalikulu la impso ndi zovuta zina zokhudzana ndi chisamaliro cha odwala kwambiri. Dipatimentiyi imaphatikiza ukadaulo wa nephrology ndi mankhwala osamalira odwala kwambiri kuti athe kuthana ndi zovuta za aimpso mwa odwala omwe akudwala kwambiri. 

1. Kusamalira kulephera kwaimpso ku ICU

Izi zimaphatikizapo kuunika mwachangu komanso kuchitapo kanthu pakuvulala koopsa kwa impso kwa odwala omwe akudwala kwambiri. Amagwiritsa ntchito njira zapamwamba zowunikira komanso njira zochizira aimpso ngati pakufunika. Imayang'ana pa kusunga ntchito ya impso yotsalira ndikupewa kuwonongeka kwina. Amakonza chithandizo ku zomwe zimayambitsa pomwe akuwongolera zovuta zomwe zimagwirizanitsidwa.

Werengani Zambiri Zokhudza Kuwongolera Kulephera kwa Renal

2. Chithandizo cha kusokonezeka kwa mawu

Kuwongolera molondola kwa madzimadzi mwa odwala omwe ali ndi vuto la impso. Imagwiritsa ntchito kuwunika kwapamwamba kwa hemodynamic kutsogolera chithandizo chamadzimadzi komanso kugwiritsa ntchito okodzetsa. Amagwiritsa ntchito njira za ultrafiltration ngati kuli kofunikira kuyang'anira kuchuluka kwamadzimadzi. Ikufuna kukhathamiritsa kutulutsa kwa m'thupi ndikupewa edema ya m'mapapo ndi zovuta zina.

3. Kusamalira matenda a electrolyte ndi acid-base

Njira yokwanira yowongolera kusalinganika kwa electrolyte ndi kusokonezeka kwa acid-base. Amagwiritsa ntchito kuwunika kosalekeza ndikuwunika pafupipafupi ma labotale kuti athandizire chithandizo. Imakhazikitsa njira zothandizira, kuphatikizapo electrolyte m'malo ndi buffer therapy. Amawongolera zomwe zimayambitsa ndikupewa ma arrhythmias ndi zovuta zina zomwe zimagwirizanitsidwa nazo.

4. Njira Yochiritsira Yobwezeretsa Impso Yopitirira (CRRT)

Continuous Renal Replacement Therapy (CRRT) ndi mtundu wa chithandizo cha dialysis chomwe chimagwiritsidwa ntchito makamaka kwa odwala omwe ali ndi vuto lalikulu la impso (AKI), makamaka akakhala osakhazikika m'magazi (mwachitsanzo, kuthamanga kwa magazi). Mosiyana ndi dialysis wamba, CRRT imachitika mosalekeza kwa maola a 24 kuti ipereke pang'onopang'ono, pang'onopang'ono kuchotsa zinyalala, ndikupangitsa kuti ikhale yabwino kwa odwala osakhazikika omwe ali m'malo osamalira odwala kwambiri.

Momwe CRRT Imagwirira Ntchito: CRRT imagwiritsa ntchito dera la extracorporeal (kunja kwa thupi) kuchotsa magazi, kusefa kudzera mu dialysis kapena hemofiltration membrane, ndikubwezeretsa magazi oyeretsedwa kwa wodwalayo. 

Zimathandizira kuchepetsa:

• Kuchuluka kwamadzimadzi
• Kusakwanira kwa electrolyte (mwachitsanzo, hyperkalemia)
• Acidosis
• Kuchotsa poizoni

Mitundu ya CRRT:

Pali mitundu inayi ikuluikulu ya CRRT, kutengera momwe madzi ndi solutes amachotsedwa:

Kupitiriza kwa Veno-Venous Hemofiltration (CVVH): Kumachotsa zosungunulira kudzera mu convection (zosungunulira zosungunulira) ndipo makamaka zimayang'ana poizoni wapakati ndi wamkulu-mamolekyu wolemera. Pamafunika kuwonjezera madzi ena m'malo kuti mukhale bwino.

Continuous Veno-Venous Hemodialysis (CVVHD): Imachotsa zosungunulira kudzera mu diffusion (concentration gradient) kuchotsa mamolekyu ang'onoang'ono monga urea ndi creatinine. Madzi a Dialysate amayenda molumikizana ndi magazi kuti achotsedwe bwino.

Kuchulukirachulukira kwa Veno-Venous Hemodiafiltration (CVVHDF):Kuphatikiza kufalikira ndi kupindika kuti kupititse patsogolo kuchotsa zosungunulira zazing'ono, zapakati, ndi zazikulu. Zimaphatikizapo zonse zamadzimadzi zolowa m'malo ndi dialysate.

Slow Continuous Ultrafiltration (SCUF): Imayang'ana kwambiri pakuchotsa madzimadzi popanda chilolezo chachikulu cha solute. Zothandiza pakuwongolera kuchuluka kwamadzimadzi kwa odwala popanda kudzikundikira zinyalala kwambiri.

5. Hemaabsorption

Njira yapadera yoyeretsera magazi kuchotsa poizoni kapena oyimira pakati. Amagwiritsa ntchito adsorbent kuti achotse zinthu zovulaza m'magazi. Zothandiza makamaka pakuwongolera sepsis, kuchuluka kwa mankhwala osokoneza bongo, ndi zina za autoimmune. Itha kuphatikizidwa ndi mankhwala ena a extracorporeal kuti agwire bwino ntchito.

6. Plasmapheresis

Njira yochizira yomwe imalekanitsa ndikuchotsa plasma m'magazi. Amagwiritsidwa ntchito pochiza matenda a autoimmune, thrombotic microangiopathies, ndi kuledzera kwina. Imachotsa ma antibodies owopsa, ma immune complexes, ndi zinthu zina zoyambitsa matenda. Itha kuchitidwa molumikizana ndi plasma kuwombola m'malo ochotsedwa plasma ndi plasma wopereka kapena albumin.

7. Njira zochiritsira zowonjezera thupi (kuphatikiza MARS)

Njira zamakono zoyeretsera magazi zoyendetsera kulephera kwa chiwindi ndi zovuta zomwe zimagwirizanitsidwa nazo. Molecular Adsorbent Recirculating System (MARS) imapereka chithandizo cha chiwindi pochotsa poizoni womangidwa ndi albumin. Njira zina zochiritsira zimaphatikizapo kusinthana kwa plasma ndi albumin dialysis pazowonetsa zosiyanasiyana. Cholinga chothandizira odwala kuti alowetse chiwindi kapena kubwezeretsa ntchito yachiwindi.

Apollo Institute of Nephrology imapereka chisamaliro chapadera kwa ana omwe ali ndi vuto la impso ndi mkodzo. Gulu losiyanasiyana ili limaphatikiza ukadaulo wa ana ndi urology kuti apereke chithandizo chokwanira, chithandizo, komanso kuwongolera kwanthawi yayitali kwa matenda obadwa nawo komanso omwe amapezeka aimpso mwa makanda, ana, ndi achinyamata. 
 

Ma laboratory apadera owunika ma microscope a zitsanzo za minofu ya impso. Amagwiritsa ntchito njira zapamwamba zowunikira molondola matenda a impso ndi kukanidwa kwa kupatsirana. Amapereka kusanthula kwatsatanetsatane kwa ma biopsies a impso kuti atsogolere zosankha zamankhwala. Amalemba ntchito akatswiri azachipatala omwe ali ndi maphunziro apadera mu aimpso pathology.
 

Kuyesa kwa majini kwapamwamba kuti mudziwe mbiri ya leukocyte antigen (HLA) ya opereka ndi olandira. Imagwiritsa ntchito njira zamamolekyu polemba HLA zokwezeka kwambiri kuti ziwongolere kufanana kwa omwe amalandira. Chofunika kwambiri pakuwunika kuyenderana ndikulosera kupulumuka kwa graft. Imathandizira onse opereka amoyo komanso omwe adamwalira omwe adapereka pulogalamu yosinthira.
 

Njira yapadera yodziwira mapuloteni enieni mu zitsanzo za minofu ya impso. Imathandizira kuzindikira matenda osiyanasiyana a impso ndi kukanidwa kwa kuikidwa. Amalola kuwonekera kwa ma cell a chitetezo chamthupi omwe amalowa ndi zolembera za matenda. Imakulitsa kulondola kwa matenda ndikuthandizira kutsogolera njira zochizira.

Werengani zambiri za Immunohistochemistry
 

Muyezo wolondola wa immunosuppressive mankhwala ndende mu zitsanzo magazi odwala. Imawonetsetsa kuti mulingo woyenera kwambiri upewe kukanidwa ndikuchepetsa zotsatira zoyipa. Amagwiritsa ntchito njira zowunikira zapamwamba pazotsatira zolondola komanso zanthawi yake. Imathandizira ma immunosuppression regimens kwa omwe amawalandira.
 

Kujambula n'kofunika kwambiri pofufuza momwe impso zimagwirira ntchito komanso momwe zimagwirira ntchito:

a) Ultrasound (kutupa kwa aimpso):

Cholinga:

• Kujambula kosasokoneza, koyamba koyesa kukula kwa impso, mawonekedwe, ndi zolakwika.

• Amazindikira zotupa, miyala, zotchinga, ndi zotupa.

Werengani zambiri za Ultrasound (Renal Sonography)

Doppler ultrasound:

• Kuwunika kuthamanga kwa magazi kupita ndi kuchokera ku impso.

Werengani zambiri za Doppler Ultrasound

b) Computed Tomography (CT):

• CT KUB (Impso, Ureters, Chikhodzodzo):

Amazindikira miyala ya impso, zotupa, ndi zolakwika zamapangidwe.

CT Angiography:

Kuwunika mitsempha yamagazi milandu yokayikira aimpso stenosis kapena matenda amtima.

Werengani zambiri za Computed Tomography (CT)

c) Kujambula kwa Magnetic Resonance (MRI):

Cholinga:

• Amapereka kujambula mwatsatanetsatane popanda ma radiation.

• Amagwiritsidwa ntchito powunika zovuta za impso, zotupa, ndi zovuta zamtima.

• MR Angiography (MRA):

• Kujambula kosasokoneza kwa mitsempha ya aimpso.

Werengani zambiri za Magnetic Resonance Imaging (MRI)

d) Makani a Nuclear Medicine:

• Renal Scintigraphy:

Imayesa kutulutsa kwa impso ndi kusefera.

• DMSA Jambulani:

Kuwunika ntchito ya impso ndi zipsera, nthawi zambiri mwa ana

Werengani zambiri za Nuclear Medicine Scans

Renal Biopsy:

Cholinga: Tizilombo tating'onoting'ono ta impso timawunikidwa pa microscope.

Zisonyezo:

• Dziwani glomerulonephritis, lupus nephritis, kapena nephrotic syndrome.

• Unikani kulephera kwa impso kosadziwika bwino.

Njira Zowongolera:

• Kuchitidwa pansi pa ultrasound kapena CT chitsogozo cholondola ndi chitetezo.

a) Kuwunika Kuthamanga kwa Magazi:

• Kuwunika mosalekeza kuti muzindikire kuthamanga kwa magazi, chomwe chimayambitsa komanso zotsatira za matenda a impso.

• Ambulatory Blood Pressure Monitoring (ABPM):

Amatsata kuthamanga kwa magazi kwa maola 24 kuti azindikire kuthamanga kwa magazi kwa masked kapena usiku.

Werengani zambiri za Blood Pressure Monitoring

b) Renal Angiography:

• Njira yojambulira molakwika pogwiritsa ntchito utoto wosiyanitsa kuti awone mitsempha ya aimpso ngati ili ndi vuto la stenosis kapena vuto la mtima.

c) Kuyeza kwa Urodynamic:

• Kuwunika ntchito ya chikhodzodzo kwa odwala omwe ali ndi vuto la mkodzo wokhudzana ndi ntchito ya impso.

Werengani zambiri za Urodynamic Testing

d) Zosindikiza:

• Imawunika chikhodzodzo ndi m'munsi mwa mkodzo ngati pali zopinga kapena zolakwika.

Werengani zambiri za Cystoscopy

a) Advanced Biomarkers:

NGAL (Neutrophil Gelatinase-Associated Lipocalin):

Kuzindikira koyambirira kwa kuvulala kwa impso (AKI).

• KIM-1 (Molekuli Yovulaza Impso-1):

Chizindikiro cha kuvulala kwa tubular mu AKI.

• Fibroblast Growth Factor 23 (FGF23):

Kuwunika kwa mineral metabolism mu matenda a impso (CKD).

b) Mayeso a Zachibadwa:

• Imazindikiritsa chibadwa monga matenda a impso a polycystic (PKD) kapena matenda a Alport.

Werengani zambiri za Genetic Testing

Zida za AI zikupangidwira:

• Kuneneratu za kupita patsogolo kwa CKD ndi AKI.

• Kupititsa patsogolo kutanthauzira kwa maphunziro ojambula zithunzi.

• Kuzindikiritsa zoopsa kuchokera ku zolemba zamagetsi zamagetsi.

• Zipangizo zam'manja zowunika mwachangu ntchito ya impso muzochitika zadzidzidzi.

• Zitsanzo zikuphatikizapo creatinine mamita kapena electrolyte analyzers.

1. Zapamwamba dialysis mayunitsi kwa muyezo hemodialysis

Magawo apamwamba a dialysis ku Apollo Institute of Nephrology amapereka chithandizo chamakono cha hemodialysis kwa odwala omwe ali ndi vuto la impso. Magawowa amakhala ndi zida zoyezera bwino kwambiri, makina owongolera amadzimadzi komanso ma electrolyte, komanso luso lapamwamba lowunikira. Amapereka zosankha za dialysis yothamanga kwambiri komanso yotsika, yogwirizana ndi zosowa za wodwala aliyense. Magawowa ali ndi machitidwe amadzi a ultrapure kuti achepetse chiopsezo cha kuipitsidwa ndi kutupa.

2. Njira Zopitilira Renal Replacement Therapy (CRRT).

Machitidwe a CRRT amapereka dialysis mosalekeza, mofatsa kwa odwala omwe ali ndi vuto lalikulu la impso kapena kuchuluka kwa madzi. Makinawa amagwira ntchito 24/7, ndikuchotsa pang'onopang'ono zonyansa ndi madzi ochulukirapo m'magazi. Amapereka njira zosiyanasiyana monga continuous venovenous hemofiltration (CVVH), hemodialysis (CVVHD), ndi hemodiafiltration (CVVHDF). CRRT ndiyothandiza makamaka kwa odwala omwe ali ndi hemodynamically osakhazikika omwe sangathe kulekerera hemodialysis yokhazikika.

3. Zida Zothandizira Zochepa Zochepa Daily Dialysis (SLEDD).

SLEDD ndi hybrid renal replacement therapy yomwe imaphatikiza mbali zonse za intermittent hemodialysis ndi CRRT. Amapereka magawo otalikirapo a dialysis (nthawi zambiri maola 6-12) pamagazi otsika komanso ma dialysate otuluka poyerekeza ndi hemodialysis wamba. Zipangizo za SLEDD ku Apollo zimalola nthawi yochizira makonda ndi mphamvu zake, zomwe zimapangitsa kuti zikhale zoyenera kwa odwala ambiri, kuphatikizapo omwe ali ndi vuto la hemodynamic.

4. Molecular Adsorbent Recirculating System (MARS) yophatikiza impso ndi chiwindi kulephera

MARS ndi njira yotsogola yachiwindi yothandizira odwala omwe ali ndi vuto lalikulu lachiwindi kapena chiwindi, nthawi zambiri amatsagana ndi vuto la impso. Amaphatikiza hemodialysis ndi albumin dialysis kuchotsa poizoni wosungunuka m'madzi komanso womangidwa ndi albumin. Dongosololi limagwiritsa ntchito dialysate yapadera yokhala ndi albumin yomwe imapangidwanso kudzera m'mizere ingapo ya adsorbent, zomwe zimalola kuchotsedwa bwino kwa poizoni wa chiwindi.

Ulendo wanu wosamalira impso umayamba ndikuwunika kwathunthu kuti mutithandize kumvetsetsa zosowa zanu zathanzi ndikupanga mapulani abwino kwambiri kwa inu. Paulendowu, mungayembekezere:

• Ndemanga ya Mbiri Yachipatala: Katswiri wa nephrologist adzakambirana za thanzi lanu lakale, mbiri yakale ya matenda a impso, ndi zizindikiro zilizonse zomwe mwakhala mukukumana nazo.
• Kufufuza Kwambiri: Kuyang'ana mozama kuti muwone thanzi lanu.
• Kuyeza matenda: Mayesero oyambirira angaphatikizepo ntchito ya magazi, urinalysis, kapena mayesero ena kuti mumvetsetse thanzi lanu la impso.
• Kuwerengetsa zowopseza: Kutengera mbiri yaumoyo wanu ndi zotsatira zoyezetsa, timawunika momwe mungatengere matenda a impso.
• Kukonzekera Chithandizo: Pambuyo powunika zomwe zapezedwa, adokotala akambirana njira zomwe angathe kulandira chithandizo ndikuyankha mafunso aliwonse, kukuthandizani kumvetsetsa njira zotsatirazi.

Mukamalandira chithandizo, kaya mukudwala dialysis kapena mukukonzekera kumuika munthu wina, gulu lathu lilipo kuti liwonetsetse kuti mukudziwitsidwa, mwamasuka, komanso mukusamalidwa bwino. Gawoli likuphatikizapo:

• Tsatanetsatane wa Njira: Tikukufotokozerani zomwe mungayembekezere kuchokera ku chithandizo chilichonse kapena njira iliyonse kuti mukhale okonzeka mokwanira.
• Chitsogozo Chokonzekera: Musanachite chilichonse, mudzalandira malangizo okuthandizani kukonzekera komanso kudzidalira.
• Zosintha Panthawi Yogona Mchipatala: Pamene muli m’chipatala, timakudziwitsani inu ndi banja lanu mmene mukupita tsiku lililonse.
• Tsiku ndi Tsiku Dokotala: Katswiri wanu wa nephrologist amakuchezerani tsiku ndi tsiku kuti awone momwe mukuchira ndikusintha zofunikira pazamankhwala anu.

Gulu Lothandizira Lothandizira: Anamwino athu, akatswiri, ndi othandizira amagwira ntchito limodzi kuwonetsetsa kuti mukulandira chisamaliro chapamwamba kwambiri.

Mukalandira chithandizo, timayang'ana kwambiri kukuthandizani kuchira ndikusintha kusintha kwa moyo wanu kudzera mu pulogalamu yochira yokhazikika:

• Mapulani Okonzanso Mwamakonda: Timakupangirani dongosolo, kuphatikiza zochitika zopititsa patsogolo thanzi la impso komanso kukhala ndi thanzi labwino.
• Chithandizo cha Dialysis: Kwa odwala omwe ali ndi dialysis, timapereka chithandizo mosalekeza ndikuwunika kuti tiwonetsetse kuti chithandizo chamankhwala chikugwira ntchito.
• Kutsata kwa Transplant: Odwala pambuyo pa kumuika amalandira chisamaliro chapadera kuti asakanidwe ndikusunga ntchito ya graft.
• Thandizo la Psychological: Timapereka chithandizo chamalingaliro kukuthandizani kuthana ndi nkhawa zilizonse, ndikuwonetsetsa kuti mukhale ndi malingaliro abwino panthawi yonse yochira.
• Malangizo pazakudya: Akatswiri athu azakudya amalangiza zakudya zopatsa impso kuti zithandizire kuchira kwanthawi yayitali komanso thanzi.

Tikufuna kuti wodwala aliyense azikhala wokonzeka komanso womasuka. Kutsatira masitepe angapo musanachitike nthawi yanu kungatithandize kukupatsani chisamaliro chabwino kwambiri.

Musanasankhidwe
Chonde nyamulani zikalata ndi zolemba zotsatirazi:

• Mbiri Yachipatala
• Zotsatira Zake Zam'mbuyomu
• Mndandanda wa Mankhwala
• Zambiri za Inshuwaransi
• Zolemba Zozindikiritsa
• Mafunso kapena Nkhawa

Zolemba Zamankhwala
Ngati alipo, bweretsani zikalata zilizonse zokhudzana ndi zaumoyo, monga:

• Malipoti ochokera ku njira zam'mbuyomu za impso
• Zotsatira zaposachedwa za labu
• Maphunziro oyerekeza (mwachitsanzo, ma ultrasound) pa CD kapena DVD
• Makalata otumiza kuchokera kwa madokotala ena
• Malipoti aposachedwa oyesa mkodzo
• Zolemba zina zilizonse zaumoyo zomwe zingakuthandizeni kumvetsetsa zosowa zanu

Paulendo Wanu
Kukambirana kwanu koyamba kumaphatikizapo:

• Kukambirana ndi Nephrologist Wanu
• Kusanthula thupi
• Ndemanga ya Medical Records
• matenda Mayesero
• Kupanga Ndondomeko Yachithandizo

Ku Apollo Institute of Nephrology, tadzipereka kupereka chisamaliro chokwanira, chaumwini paulendo wanu wonse waumoyo wa impso.

Musanafike, timakuthandizani kukonzekera ndi kukonzekera ulendo wanu:

• Ndemanga ya Medical Documentation: Gulu lathu limawunikanso zolemba zanu zachipatala kuti mumvetsetse zosowa zanu ndikupanga dongosolo lamankhwala.
• Kukonzekera Chithandizo: Timapanga dongosolo lachisamaliro logwirizana ndi chikhalidwe cha impso zanu.
• Kuyerekeza Mtengo: Timapereka zoyerekeza mtengo wowonekera kuti zikuthandizeni kukonza zandalama.

Thandizo la Visa: Timathandizira pazofunikira za visa ndikukupatsirani zolemba zokuthandizani paulendo wanu wachipatala.

Muli ku Apollo Institute of Nephrology, tikuwonetsetsa kuti inu ndi banja lanu mukumva kuthandizidwa mokwanira:

• Othandizira Odzipereka: Mudzakhala ndi wogwirizanitsa chisamaliro chaumwini kuti akutsogolereni pa sitepe iliyonse yakukhala kwanu.
• Thandizo la Zinenero: Omasulira ophunzitsidwa bwino alipo kuti akuthandizeni kulankhulana momveka bwino ndi gulu lanu lazaumoyo m'chinenero chomwe mumakonda.
• Chikhalidwe: Timalemekeza zosowa za chikhalidwe ndikupereka ntchito zomwe zimagwirizana ndi zomwe mumakonda.
• Malo Ogona Mabanja: Timakuthandizani kupeza malo abwino ogona a banja lanu.

Zosintha Nthawi Zonse: Gulu lathu limakupatsirani zosintha pazamankhwala anu ndikuchira kuti mudzidziwitse inu ndi banja lanu.

Mukatha kulandira chithandizo, tikupitiliza kukuthandizani kuti muchiritse bwino:

• Kukonzekera Kutsatira: Timakonzekera nthawi yotsatila ndi zokambirana kuti tiziyang'anira kuchira kwanu.
• Zosankha za Telemedicine: Mutha kukhala olumikizana ndi akatswiri athu a nephrologists kudzera pazokambirana zenizeni.
• Kulumikizana ndi Madokotala Akudziko Lanyumba: Timagwirizana ndi dokotala wanu wapafupi kuti muwonetsetse kuti mukulandira chithandizo chokhazikika.

Zolemba Zaumoyo Zapa digito: Pezani zolemba zanu zachipatala pa intaneti kuti mugawane mosavuta ndi zosowa zanu zamtsogolo.