Membranous nephropathy

Membranous nephropathy ndimatenda a impso omwe amatsogolera ku kusintha ndi kutupa kwa zomwe zili mkati mwa impso zomwe zimathandiza kusefa zinyalala ndi madzi. Kutupa kumatha kubweretsa mavuto ndi ntchito ya impso.

Membranous nephropathy imayambitsidwa chifukwa chakulimba kwa gawo la glomerular chapansi nembanemba. Kakhungu kam'chipinda chapansi panthaka ndi gawo la impso zomwe zimathandiza kusefa zinyalala ndi madzi owonjezera am'magazi. Chifukwa chenicheni chakukula kumeneku sikudziwika.

Kakhungu konyezimira ka glomerular sikugwira ntchito bwino. Zotsatira zake, mapuloteni ambiri amatayika mumkodzo.

Matendawa ndi chimodzi mwazomwe zimayambitsa matenda a nephrotic. Ili ndi gulu lazizindikiro zomwe zimaphatikizapo mapuloteni mumkodzo, kuchepa kwamapuloteni m'magazi, kuchuluka kwama cholesterol, kuchuluka kwa triglyceride, ndi kutupa. Membranous nephropathy atha kukhala matenda a impso oyamba, kapena atha kuphatikizidwa ndi mikhalidwe ina.

Zotsatirazi zimawonjezera chiopsezo chanu:

• Khansa, makamaka khansa ya m'mapapo ndi m'matumbo
• Kuwonetsedwa kwa poizoni, kuphatikiza golide ndi mercury
• Matenda, kuphatikizapo hepatitis B, malungo, syphilis, ndi endocarditis
• Mankhwala, kuphatikizapo penicillamine, trimethadione, ndi mafuta owalitsa khungu
• Matenda a lupus erythematosus, nyamakazi ya nyamakazi, Matenda a manda, ndi zovuta zina za autoimmune

Vutoli limachitika msinkhu uliwonse, koma limafala kwambiri pambuyo pa zaka 40.

Zizindikiro nthawi zambiri zimayamba pang'onopang'ono pakapita nthawi, ndipo zimatha kuphatikiza:

• Edema (kutupa) m'dera lililonse la thupi
• Kutopa
• Kuwoneka kwamatope mkodzo (chifukwa cha kuchuluka kwa mapuloteni)
• Kulakalaka kudya
• Kukodza, usiku kwambiri
• Kulemera

Kuyezetsa thupi kumatha kuwonetsa kutupa (edema).

Kuwunika kwamitsempha kumatha kuwonetsa kuchuluka kwa mapuloteni mumkodzo. Pakhoza kukhala magazi ena mumkodzo.Kuchuluka kwa kusefera kwa glomerular ("kuthamanga" komwe impso zimatsukira magazi) nthawi zambiri kumakhala pafupifupi.

Mayeso ena atha kuchitidwa kuti muwone momwe impso zikugwirira ntchito komanso momwe thupi limasinthira ndi vuto la impso. Izi zikuphatikiza:

• Albumin - magazi ndi mkodzo
• Magazi urea asafe (BUN)
• Creatinine - magazi
• Chilolezo cha Creatinine
• Gulu la lipid
• Mapuloteni - magazi ndi mkodzo

Kufufuza kwa impso kumatsimikizira matendawa.

Mayesero otsatirawa angathandize kudziwa chomwe chimayambitsa matendawa:

• Mayeso a antiinuclear antibodies
• Anti-strand DNA, ngati mayeso a antiinuclear antibodies ndiabwino
• Kuyesa magazi kuti muwone ngati matenda a hepatitis B, hepatitis C, ndi syphilis
• Malizitsani milingo
• Mayeso a Cryoglobulin

Cholinga cha chithandizo ndikuchepetsa zizindikiro ndikuchepetsa kukula kwa matendawa.

Kulamulira kuthamanga kwa magazi ndiye njira yofunika kwambiri yochedwetsera kuwonongeka kwa impso. Cholinga ndikuteteza kuthamanga kwa magazi pansi kapena pansi pa 130/80 mm Hg.

Cholesterol wamagazi ndi milingo ya triglyceride iyenera kuthandizidwa kuti muchepetse chiopsezo cha atherosclerosis. Komabe, chakudya chamafuta ochepa, mafuta ochepa mafuta nthawi zambiri sichithandiza anthu omwe ali ndi nephropathy ya membranous.

Mankhwala omwe amagwiritsidwa ntchito pochiza matenda am'mimba ndi awa:

• Angiotensin-converting enzyme (ACE) inhibitors ndi angiotensin receptor blockers (ARBs) kuti achepetse kuthamanga kwa magazi
• Corticosteroids ndi mankhwala ena omwe amalepheretsa chitetezo cha mthupi
• Mankhwala (nthawi zambiri ma statins) ochepetsa cholesterol ndi triglyceride
• Mapiritsi amadzi (okodzetsa) kuti achepetse kutupa
• Ochepetsa magazi kuti achepetse chiopsezo chamagazi m'mapapu ndi miyendo

Zakudya zopanda mapuloteni ochepa zitha kukhala zothandiza. Pangakhale chakudya chama protein ochepa (1 gramu) ya kilogalamu pa kilogalamu ya kulemera kwa thupi patsiku.

Vitamini D angafunike kusinthidwa ngati matenda a nephrotic atenga nthawi yayitali (osachiritsika) ndipo samayankha mankhwala.

Matendawa amachulukitsa chiwopsezo cha magazi m'mapapo ndi m'miyendo. Ochepetsa magazi atha kulembedwa kuti athetse zovuta izi.

Maganizo ake amasiyana, kutengera kuchuluka kwa kuchuluka kwa mapuloteni. Pakhoza kukhala nthawi yopanda zizindikilo komanso kuwonongeka kwanthawi zina. Nthawi zina, vutoli limatha, popanda mankhwala.

Anthu ambiri omwe ali ndi matendawa adzawonongeka impso ndipo anthu ena amayamba kudwala matenda a impso.

Zovuta zomwe zingachitike chifukwa cha matendawa ndi monga:

• Aakulu aimpso kulephera
• Thrombosis yoopsa kwambiri
• Mapeto a matenda a impso
• Matenda a Nephrotic
• Kuphatikizika kwa pulmonary
• Aimpso mtsempha thrombosis

Itanani kuti mudzakumane ndi wokuthandizani ngati:

• Muli ndi zizindikilo za nephropathy
• Zizindikiro zanu zimaipiraipira kapena sizimatha
• Mumakhala ndi zizindikilo zatsopano
• Mwachepetsa kutulutsa mkodzo

Kuchiza mwachangu mavuto ndikupewa zinthu zomwe zingayambitse nephropathy ya membranous kumachepetsa chiopsezo chanu.

Membranous glomerulonephritis; Chikumbutso cha GN; Zowonjezera glomerulonephritis; Glomerulonephritis - nembanemba; MGN

• Matenda a impso

Radhakrishnan J, Appel GB. Matenda a Glomerular ndi syphrotic syndromes. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ (Adasankhidwa) Matenda oyamba a glomerular. Mu: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, olemba. Brenner ndi Rector a Impso. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 31.

Salant DJ, Cattran DC. Membranous nephropathy. Mu: Feehally J, Floege J, Tonelli M, Johnson RJ, olemba. Chachikulu Chachipatala Nephrology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: chap 20.