Nephritis yapakati

Interstitial nephritis ndi vuto la impso pomwe malo pakati pa ziphuphu za impso amatupa (kutupa). Izi zitha kuyambitsa mavuto ndi momwe impso zanu zimagwirira ntchito.

Interstitial nephritis itha kukhala yosakhalitsa (yovuta), kapena ikhoza kukhala yokhalitsa (yanthawi yayitali) ndikuwonjezeka pakapita nthawi.

The pachimake mawonekedwe a interstitial nephritis nthawi zambiri amayamba ndi zotsatira zoyipa za mankhwala enaake.

Zotsatirazi zingayambitse nephritis yapakati:

• Thupi lawo siligwirizana mankhwala (pachimake interstitial Matupi nephritis).
• Matenda osokoneza bongo, monga antitubular basement membrane matenda, matenda a Kawasaki, Sjögren syndrome, systemic lupus erythematosus, kapena granulomatosis ndi polyangiitis
• Matenda.
• Kugwiritsa ntchito mankhwala kwa nthawi yayitali monga acetaminophen (Tylenol), aspirin, ndi ma anti-steroidal anti-inflammatory (NSAIDs). Izi zimatchedwa analgesic nephropathy.
• Zotsatira zoyipa za maantibayotiki ena monga penicillin, ampicillin, methicillin, ndi mankhwala a sulfonamide.
• Zotsatira zoyipa za mankhwala ena monga furosemide, thiazide diuretics, omeprazole, triamterene, ndi allopurinol.
• Potaziyamu pang'ono m'magazi anu.
• Zakudya zambiri za calcium kapena uric acid m'magazi anu.

Interstitial nephritis imatha kuyambitsa mavuto a impso ochepa, kuphatikiza kulephera kwa impso. Pafupifupi theka la milandu, anthu adzakhala atachepetsa mkodzo komanso zizindikilo zina za impso zoyipa.

Zizindikiro za matendawa zingaphatikizepo:

• Magazi mkodzo
• Malungo
• Kuchuluka kapena kuchepa kwa mkodzo
• Kusintha kwa malingaliro (kuwodzera, kusokonezeka, kukomoka)
• Nseru, kusanza
• Kutupa
• Kutupa kwa gawo lililonse la thupi
• Kulemera (kuchokera pakusunga madzi)

Wothandizira zaumoyo adzayesa. Izi zitha kuwulula:

• Mapapu osazolowereka kapena mtima umamveka
• Kuthamanga kwa magazi
• Zamadzimadzi m'mapapu (pulmonary edema)

Mayeso wamba amaphatikizapo:

• Mitsempha yamagazi yamagazi
• Magazi amadzimadzi
• BUN ndi milingo ya creatinine yamagazi
• Kuwerengera kwathunthu kwa magazi
• Kusokoneza impso
• Impso ultrasound
• Kupenda kwamadzi

Chithandizo chimadalira chifukwa cha vutoli. Kupewa mankhwala omwe angayambitse vutoli kumatha kuthetsa zisonyezo mwachangu.

Kuchepetsa mchere komanso madzimadzi pazakudya kumatha kukulitsa kutupa komanso kuthamanga kwa magazi. Kuchepetsa mapuloteni pazakudya kumatha kuthandizira kuwongolera zinyalala zamagazi (azotemia), zomwe zimatha kubweretsa zizindikiritso za impso zoyipa.

Ngati dialysis ndiyofunika, pamafunika nthawi yochepa.

Corticosteroids kapena mankhwala amphamvu odana ndi zotupa monga cyclophosphamide nthawi zina amatha kukhala othandiza.

Nthawi zambiri, interstitial nephritis ndimatenda akanthawi kochepa. Nthawi zambiri, zimatha kuwononga zinthu mpaka kalekale, kuphatikiza impso za nthawi yayitali (zosatha).

Nephritis yoyipa kwambiri imatha kukhala yowopsa kwambiri ndipo imatha kubweretsa kuwonongeka kwa impso kwa nthawi yayitali mwa okalamba.

Metabolic acidosis imatha kuchitika chifukwa impso sizingathe kuchotsa asidi wokwanira. Vutoli limatha kubweretsa kulephera koopsa kwa impso kapena matenda a impso.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo za nephritis yapakati.

Ngati muli ndi nephritis yapakatikati, itanani omwe akukuthandizani mukapeza zizindikilo zatsopano, makamaka ngati simukukhala tcheru kapena kuchepa kwa mkodzo.

Nthawi zambiri, matendawa sangathe kupewedwa. Kupewa kapena kuchepetsa kugwiritsa ntchito mankhwala omwe angayambitse vutoli kungakuthandizeni kuchepetsa ngozi. Ngati zingafunike, omwe akukuthandizani adzakuwuzani mankhwala oti musiye kapena kuchepetsa.

Tubulointerstitial nephritis; Nephritis - zamkati; Pachimake interstitial (matupi awo sagwirizana) nephritis

• Matenda a impso

Neilson EG. Tubulointerstitial nephritis. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 122.

Perazella MA, Rosner MH. Matenda a tubulointerstitial. Mu: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, olemba. Brenner ndi Rector a Impso. 10th ed. Philadelphia, PA: Elsevier; 2020: chap 35.

Tanaka T, Nangaku M. Chronic interstitial nephritis. Mu: Feehally J, Floege J, Tonelli M, Johnson RJ, olemba. Chachikulu Chachipatala Nephrology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: mutu 62.