Iimvavanyo zokuSebenza kwezintso (KFT)

Yintoni umsebenzi oqhelekileyo wezintso?

Izintso ngamalungu amile okwembotyi kwaye zilingana nenqindi. Izintso ezimbini zilala ngapha nangapha komnqonqo, ngasemva kwesisu nangaphantsi kweembambo.

Izintso zigcina inqanaba lomzimba lamanzi kunye neeminerali ezahlukeneyo ezibalulekileyo. Bahluza inkunkuma kunye nolwelo olugqithisileyo egazini kwaye bazikhuphe emzimbeni njengomchamo.

Imisebenzi eyongezelelweyo yezintso ibandakanya ukuveliswa kwezi:

• Vitamin D
• Iiseli ezibomvu zegazi
• IiHormones ezilawulayo ifuthe legazi

Ziziphi iimpawu zeengxaki zezintso?

Iimpawu ezinokubonisa ukuba ingxaki yezintso ziquka:

• Igazi elonyukayo
• Igazi kumchamo
• Ukufuna ukuchama rhoqo
• Ubunzima bokuqalisa ukuchama
• Ukuchama kabuhlungu
• Ukudumba kwezandla neenyawo 

Ugqirha angacebisa nini i-KFT?

• ukuba ugqirha ucinga ukuba izintso zisenokungasebenzi ngokusekelwe kumngcipheko, iimpawu zeklinikhi, kunye neempawu
• Ukuhlola nokuvavanya unobangela wokungasebenzi kakuhle kwezintso
• Ukuba iimeko ezinokulimaza izintso, ezifana iswekile okanye uxinzelelo lwegazi oluphezulu, nalo luhlala kunye
• Ukubeka iliso kwinkqubela phambili yesifo sezintso kunye nokusabela kunyango

Zeziphi iintlobo zee-KFTs?

Iindlela ezahlukeneyo zokuvavanya ukusebenza kwezintso ziquka:

• Uhlalutyo lomchamo: Ihlola iprotheyini, igazi, ubovu, ibhaktheriya, kunye neswekile emchameni. Inokukunceda ukufumanisa izintso ezahlukeneyo kunye ukuphazamiseka kwendlela yomchamo, kubandakanya isifo esesigxina, isifo seswekile, usulelo lwesinyi, nezintso. Ekubeni kukho izizathu ezahlukeneyo zeprotheni kumchamo, isifo sezintso asinakuhlala singunobangela. Ugqirha unokuphinda olu vavanyo emva kweeveki ezimbalwa ukuze abone ukuba iziphumo ziyafana. Ezinye iimvavanyo zomchamo zifuna umthamo omncinci kuphela, ngelixa ezinye zifuna ukuqokelelwa komchamo kwiiyure ezingamashumi amabini anesine zokugqibela. Uvavanyo lomchamo lweyure ezingama-24 luya kubonisa ukuba ungakanani umchamo oveliswa zizintso kwaye ulinganise ngokuchanekileyo ukuba zisebenza kakuhle kangakanani izintso zakho mihla le.

Isikhongozeli siya kubonelelwa ukuze siqokelele isampulu yomchamo kwaye emva koko sithunyelwe elebhu ukuze sihlalutywe kwiklinikhi kagqirha okanye Esibhedlele. 

• Iprotheyini yoMchamo: Ubukho beprotheyini kumchamo kwaziwa ngokuba yiproteinuria. Unokuba nalo mlinganiso njengenxalenye yohlalutyo lokuchama okanye uvavanyo lwe-dipstick. Uvavanyo lwe-dipstick oluqinisekileyo (≥1+) kufuneka luqinisekiswe:

• Ukujonga i-microalbuminuria: Olu luvavanyo olunovakalelo lwedipstick olunokubona isixa esincinci sealbumin (olona hlobo luxhaphakileyo lweprotein yomchamo). Izixa eziphakamileyo zealbumin kumchamo zinokubonisa ukungasebenzi kakuhle kwezintso. Abantu abasengozini yokungasebenzi kakuhle kwezintso (umzekelo, abo bane iswekile or xi nzelelo) kufuneka babe nolu vavanyo okanye i-albumin-to-creatinine ratio (ACR) ukuba uvavanyo lwabo oluqhelekileyo lwe-dipstick lwe-proteinuria alunayo.
• I-ACR: Xa sahlula isixa se-albumin yomchamo nge-creatinine yomchamo, sifumana i-ACR. I-ACR <30 ithathwa njengesiqhelo. I-ACR phakathi kwe-30-300 ibonisa i-albuminuria ephakathi. I-ACR> 300 ithetha ukuba i-albuminuria enzima. 

• Ukususwa kweCreatinine: Olu vavanyo luthelekisa inqanaba le-creatinine kwisampulu yeyure ezingama-24 yomchamo kunye nobuninzi be-creatinine egazini ukubonisa ukuba zingakanani na inkunkuma ehluzwa zizintso ngomzuzu ngamnye.

• Iisampulu zegazi: Iimvavanyo ezimbini ezifuna isampulu yegazi ethathwe kwiklinikhi kagqirha okanye kwindawo yasesibhedlele ziquka i-BUN kunye novavanyo lwe-serum creatinine. Igcisa liqala libopha ibhanti elastiki kwingalo engaphezulu, eyenza imithambo ekwigophe lengalo ibonakale ngakumbi. Uchwephesha ucoca indawo ephezu komthambo, emva koko atyibilikise inaliti emgongxo esikhumbeni nakumthambo, nto leyo eyenza ukuba igazi limpompoze kwityhubhu yovavanyo. Emva kovavanyo, uchwepheshe uya kubeka i-gauze kunye ne-bandage phezu kwendawo yokubhoboza. Umchwephesha uya kuthumela ityhubhu kwilebhu ukuze kuhlalutywe.

• Uvavanyo lweSerum creatinine: I-Creatinine yimveliso eqhelekileyo yokuwohloka kwemisipha yomzimba, edla ngokuhluzwa ngokupheleleyo ligazi ngezintso. NgokweNational Kidney Foundation, inqanaba le-creatinine> 1.2 milligrams/deciliter (mg/dL) kwabasetyhini kunye> 1.4 mg/dL emadodeni libonisa ukungasebenzi kakuhle kwezintso. Ngokungasebenzi kakuhle kwezintso, izinga le-creatinine egazini liyenyuka. Uvavanyo lwe-serum creatinine luvavanyo olubalulekileyo lomsebenzi wezintso kwaye lumisela ukuphakama kwe-serum creatinine.

• Urea nitrogen yegazi (BUN): The Uvavanyo lwe-BUN inceda ukugqiba inani le-urea nitrogen, imveliso yokuchithwa kweprotheni yokutya, egazini. Kanye nomonakalo wezintso, i-BUN ephakamileyo inokuvela ekutyalweni kwamayeza athile, kuquka i-aspirin kunye nezinye iintlobo ze-antibiotics. Abantu kufuneka bazise oogqirha babo malunga neyeza labo kunye nembali yokuthatha. Ukuba olu vavanyo luyafuneka, umntu uya kufuneka ayeke la mayeza kwiintsuku ezimbalwa phambi kovavanyo. Izinga le-BUN eliqhelekileyo lisuka kwi-7 kunye ne-20 mg / dL. Njengoko umsebenzi wezintso uyehla ngokuthe ngcembe, inqanaba le-BUN liyenyuka, kwaye ixabiso eliphezulu lingabonisa imiba yezempilo, kubandakanya ukungasebenzi kakuhle kwezintso.

• Iqondo lokuHlufa kweGlomerular (GFR): Oku kuvavanya ukuba izintso zihluza kakuhle kangakanani inkunkuma kunye nolwelo olugqithileyo egazini. Sinokumisela izinga ngokuqwalasela iiparamitha ezahlukeneyo zeklinikhi:
  • Inqanaba leSerum creatinine
  • ubudala
  • Gender
  • Race
  • ukuphakama
  • ubunzima

Olu vavanyo lulinganisa indlela izintso ezisusa ngayo inkunkuma kunye nolwelo olugqithisileyo egazini. I-GFR eqhelekileyo inokwahluka ngokweminyaka (inokuncipha ngobudala). Sinokubala i-GFR njenge-millilitres/minute/1.73m². Ixabiso eliqhelekileyo le-GFR yi-90 okanye ngaphezulu. I-GFR engaphantsi kwe-60 ibonisa ukuba uhlobo oluthile lwe-renal dysfunction lubekiwe. Ukuba i-GFR yomntu iwela ngaphantsi kwe-15, basengozini enkulu yokufuna dialysis okanye ukutshintshwa.

Uvavanyo lomfanekiso olunokunceda ngokuhlanganisa uxilongo kunye nee-KFTs

• omoya kunye neCT: Zingasetyenziselwa ukujonga izinto ezingaqhelekanga kubungakanani bezintso okanye indawo okanye imiqobo efana namatye okanye amathumba.
• Sinokufuna a izintso biopsy kwezi meko zilandelayo:
  • Ukuchonga ukuqala kwesifo kunye nokuqhubela phambili kunye nokumisela impendulo enokubakho kunyango
  • Ukuvavanya ubungakanani bomonakalo wezintso 
  • Ukufumana izizathu ukufakelwa kweengtso ukwala

Zeziphi iindlela zonyango lwesifo sezintso kwangoko?

Ukuba ii-KFTs zibonisa isifo sezintso ezisisiseko, ukungenelela kolawulo logqirha kuya kujolisa kwi-causal pathology. Ukongezelela ekufundiseni umntu ngendlela aphila ngayo kunye nohlengahlengiso kwindlela atya ngayo, oogqirha banokumnika amayeza okulawula uxinezeleko nesifo seswekile. Ukuthunyelwa ku-a i-cardiologist or i-endocrinologist kunokufuneka ngokuxhomekeke kwiziphumo zovavanyo kunye nomfanekiso wekliniki jikelele. Phinda ii-KFTs ziya kufuneka ukujonga ukuqhubeka kunye nokusabela kunyango. 

Ukuziphendulela: Eli nqaku lenzelwe iinjongo zolwazi kuphela kwaye ayithathi indawo yeengcebiso zonyango. Qhagamshelana nengcali yezempilo ukuze ufumane ukuxilongwa, unyango, okanye iinkxalabo.