Ukuhlolwa Kokusebenza Kwezinso (KFT)

Uyini umsebenzi ojwayelekile wezinso?

Izinso ziyizitho ezimise okwebhontshisi futhi zingangenqindi. Izinso ezimbili zilala nhlangothi zombili zomgogodla, ngemuva kwesisu nangaphansi kwezimbambo.

Izinso zigcina izinga lamanzi emzimbeni kanye namaminerali abalulekile ahlukahlukene. Zihlunga izinto ezilahlwayo kanye noketshezi oluningi egazini futhi zikukhiphe emzimbeni njengomchamo.

Imisebenzi eyengeziwe yezinso ihlanganisa ukukhiqizwa:

• Vitamin D
• Amaseli abomvu egazi
• Amahomoni alawulayo ukushaya kwegazi

Yiziphi izimpawu zezinkinga zezinso?

Izimpawu ezingase zibonise inkinga ngezinso zihlanganisa:

• Umfutho wegazi ophezulu
• Igazi emchameni
• Ukufisa ukuchama njalo
• Ubunzima bokuqalisa ukuchama
• Ukuchama kabuhlungu
• Ukuvuvukala kwezandla nezinyawo 

Udokotela angancoma nini i-KFT?

• Uma udokotela ucabanga ukuthi izinso kungenzeka zingasebenzi ngokusekelwe ezicini eziyingozi, izimpawu zomtholampilo, nezimpawu
• Ukuhlola nokuhlola imbangela yokungasebenzi kahle kwezinso
• Uma izimo ezingalimaza izinso, njenge sikashukela noma umfutho wegazi ophakeme, nawo uhlala ndawonye
• Ukuqapha ukuqhubeka kwesifo sezinso kanye nokusabela ekwelashweni

Yiziphi izinhlobo zama-KFT?

Izindlela ezahlukene zokuhlola ukusebenza kwezinso zihlanganisa:

• I-Urinalysis: Ihlola amaprotheni, igazi, ubomvu, amagciwane, noshukela emchameni. Kungasiza ukubona izinso ezihlukahlukene futhi ukuphazamiseka kwendlela yomchamo, kuhlanganise isifo sezinso, isifo sikashukela, izifo zesinye, namatshe ezinso. Njengoba kunezizathu ezihlukene zamaprotheni emchameni, isifo sezinso singase singabi yimbangela ngaso sonke isikhathi. Udokotela angase aphinde lokhu kuhlolwa ngemva kwamasonto ambalwa ukuze abone ukuthi imiphumela iyafana yini. Okunye ukuhlolwa komchamo kudinga umthamo omncane kuphela, kuyilapho okunye kudinga ukuqoqwa komchamo emahoreni angamashumi amabili nane okugcina. Ukuhlolwa komchamo wamahora angu-24 kuzobonisa ukuthi ungakanani umchamo okhiqizwa izinso zakho futhi kukalwe ngokunembile ukuthi izinso zakho zisebenza kahle kangakanani nsuku zonke.

Kuzohlinzekwa isiqukathi ukuze kuqoqwe isampula lomchamo bese sithunyelwa elebhu ukuze sihlaziywe emtholampilo kadokotela noma esibhedlela. 

• Iphrotheni ye-Urinary: Ukuba khona kwamaprotheni emchameni kwaziwa ngokuthi yi-proteinuria. Ungase ube nalesi silinganiso njengengxenye yokuhlaziywa komchamo noma ukuhlolwa kwe-dipstick. Ukuhlolwa kwe-dipstick evumayo (≥1+) kufanele kuqinisekiswe:

• Ukuhlola i-microalbuminuria: Lokhu ukuhlola kwe-dipstick okuzwela kakhulu okungathola inani elincane le-albumin (uhlobo oluvame kakhulu lwephrotheni yomchamo). Amanani aphezulu e-albumin emchameni angase abonise ukungasebenzi kahle kwezinso. Abantu abasengozini yokungasebenzi kahle kwezinso (isibonelo, labo abane sikashukela or nomfutho wegazi ophezulu) kufanele babe nalokhu kuhlolwa noma isilinganiso se-albumin-to-creatinine (ACR) uma ukuhlolwa kwabo okujwayelekile kwe-dipstick kwe-proteinuria kungenayo.
• I-ACR: Lapho sihlukanisa inani le-albumin yomchamo nge-creatinine yomchamo, sithola i-ACR. I-ACR <30 ibhekwa njengejwayelekile. I-ACR ephakathi kuka-30-300 ibonisa i-albuminuria emaphakathi. I-ACR> 300 isho i-albuminuria enzima. 

• Ukususwa kwe-Creatinine: Lokhu kuhlola kuqhathanisa izinga le-creatinine kusampula yomchamo wamahora angu-24 nenani le-creatinine egazini ukuze kubonise ukuthi ingakanani imfucuza izinso eziyihlungayo ngomzuzu ngamunye.

• Amasampula egazi: Ukuhlola okubili okudinga isampula yegazi elithathwe emtholampilo kadokotela noma endaweni yasesibhedlela kufaka phakathi ukuhlolwa kwe-BUN kanye ne-serum creatinine. Uchwepheshe uqale abophe ibhande elinwebekayo engalweni engenhla, okwenza imithambo ekugobiseni kwengalo igqame kakhulu. Uchwepheshe uhlanza indawo phezu komthambo, ngemva kwalokho ashutheke inaliti engenalutho esikhumbeni nasemithanjeni, enze igazi ligeleze lingene eshubhuni lokuhlola. Ngemuva kokuhlolwa, uchwepheshe uzobeka i-gauze ne-bandage phezu kwendawo yokubhoboza. Uchwepheshe uzothumela ishubhu elebhu ukuze ihlaziywe.

• Ukuhlolwa kwe-serum creatinine: I-Creatinine iwumkhiqizo ojwayelekile wokuwohloka kokuguga nokudabuka kwemisipha, okuvamise ukuhlungwa ngokuphelele yizinso egazini. NgokweNational Kidney Foundation, izinga le-creatinine> 1.2 milligrams/deciliter (mg/dL) kwabesifazane kanye> 1.4 mg/dL kwabesilisa libonisa ukungasebenzi kahle kwezinso. Ngokungasebenzi kahle kwezinso okuqhubekayo, izinga le-creatinine egazini liyakhuphuka. Ukuhlolwa kwe-serum creatinine kuwukuhlola okubalulekile kokusebenza kwezinso futhi kunquma ukuphakama kwe-serum creatinine.

• I-urea nitrogen yegazi (BUN): The Ukuhlolwa kwe-BUN kusiza ukunquma inani le-urea nitrogen, umkhiqizo wokuwohloka kwamaprotheni okudla, egazini. Kanye nokulimala kwezinso, i-BUN ephakeme ingase futhi iphakame ekuphuzeni imithi ethile, kuhlanganise ne-aspirin nezinye izinhlobo zemithi elwa namagciwane. Abantu ngabanye badinga ukwazisa odokotela babo mayelana nomlando wabo wokuphuza izidakamizwa kanye nesengezo. Uma lokhu kuhlolwa kuyadingeka, umuntu uzodinga ukuyeka le mithi izinsuku ezimbalwa ngaphambi kokuhlolwa. Izinga elijwayelekile le-BUN lisukela ku-7 kanye no-20 mg/dL. Njengoba ukusebenza kwezinso kuncipha kancane kancane, izinga le-BUN liyakhuphuka, futhi inani eliphakeme lingabonisa izinkinga zezempilo, okuhlanganisa ukungasebenzi kahle kwezinso.

• I-Glomerular Filtration Rate (GFR): Lokhu kuhlola ukuthi izinso zihlunga kahle kangakanani imfucuza kanye noketshezi oluningi egazini. Singanquma izinga ngokucabangela imingcele ehlukahlukene yomtholampilo:
  • Izinga le-serum creatinine
  • Ubudala
  • Ubulili
  • Race
  • Ukuphakama
  • Isisindo

Lokhu kuhlola kukala ukuthi izinso ziwukhipha kanjani ukungcola kanye noketshezi oluningi egazini. I-GFR evamile ingahluka kuye ngeminyaka (ingancipha ngokuya ngeminyaka). Singabala i-GFR njengamamililitha/umzuzu/1.73m². Inani elijwayelekile le-GFR lingu-90 noma ngaphezulu. I-GFR engaphansi kuka-60 isho ukuthi uhlobo oluthile lokungasebenzi kahle kwezinso seluqalile. Uma i-GFR yomuntu iwela ngaphansi kuka-15, basengozini enkulu yokudinga dialysis noma ukufakelwa kabusha.

Ukuhlola Ukucabanga okungasiza ngokuhlanganisa ukuxilonga kanye nama-KFT

• ultrasound kanye ne-CT: Zingase zisetshenziselwe ukubheka okungavamile kusayizi wezinso noma indawo noma izithiyo ezinjengamatshe noma izimila.
• Singase sidinge a izinso i-biopsy ezimweni ezilandelayo:
  • Ukuhlonza ukuqala nokuqhubeka kwesifo nokunquma impendulo engaba khona ekwelashweni
  • Ukuhlola izinga lokulimala kwezinso 
  • Ukuze uthole izinkinga ukufakelwa kwezinso ukwenqatshwa

Yiziphi izindlela zokwelapha isifo sezinso zakuqala?

Uma ama-KFT ebonisa isifo sezinso esingaphansi, ukungenelela kokuphathwa kodokotela kuzokhomba i-causal pathology. Ngaphezu kokufundisa umuntu ngokuphathelene nendlela yokuphila kanye nokuguqulwa kokudla, odokotela bangase banikeze imithi yokulawula umfutho wegazi ophakeme nesifo sikashukela. Ukudluliselwa ku-a i-cardiologist or i-endocrinologist kungase kudingeke kuye ngemiphumela yokuhlolwa kanye nesithombe somtholampilo sisonke. Ama-KFT aphindayo azodingeka ukuze kuqashwe ukuqhubeka kanye nokusabela ekwelashweni. 

Umshwana wokuzihlangula: Lesi sihloko senzelwe izinjongo zokwaziswa kuphela futhi hhayi esikhundleni seseluleko sezokwelapha. Xhumana nochwepheshe bezokunakekelwa kwempilo ukuze uthole ukuxilongwa, ukwelashwa, noma okukukhathazayo.