Matenda a Nephrotic

Nephrotic syndrome ndi gulu lazizindikiro zomwe zimaphatikizapo mapuloteni mumkodzo, kuchuluka kwa mapuloteni m'magazi, kuchuluka kwama cholesterol, kuchuluka kwa triglyceride, chiwopsezo chowonjezeka chamagazi, ndi kutupa.

Nephrotic syndrome imayamba chifukwa cha zovuta zosiyanasiyana zomwe zimawononga impso. Kuwonongeka kumeneku kumabweretsa kutulutsa mapuloteni ambiri mumkodzo.

Chomwe chimayambitsa ana kwambiri ndimatenda ochepa osintha. Membranous glomerulonephritis ndiye chifukwa chofala kwambiri mwa akulu. M'matenda onsewa, glomeruli mu impso zawonongeka. Glomeruli ndi nyumba zomwe zimathandiza kusefa zinyalala ndi madzi.

Izi zitha kuchitika kuchokera ku:

• Khansa
• Matenda monga matenda ashuga, systemic lupus erythematosus, myeloma angapo, ndi amyloidosis
• Matenda a chibadwa
• Matenda amthupi
• Matenda (monga strep throat, hepatitis, kapena mononucleosis)
• Kugwiritsa ntchito mankhwala ena

Zitha kuchitika ndimatenda a impso monga:

• Maganizo a glomerulosclerosis
• Glomerulonephritis
• Mesangiocapillary glomerulonephritis

Nephrotic syndrome imatha kukhudza mibadwo yonse. Kwa ana, ndizofala kwambiri pakati pa zaka 2 mpaka 6. Matendawa amapezeka kwambiri mwa amuna kuposa akazi.

Kutupa (edema) ndi chizindikiro chofala kwambiri. Zitha kuchitika:

• Pamaso ndi mozungulira maso (kutupa kwa nkhope)
• Mu mikono ndi miyendo, makamaka kumapazi ndi akakolo
• M'mimba (mimba yotupa)

Zizindikiro zina ndizo:

• Kutupa pakhungu kapena zilonda
• Kuwonekera kwamatope mkodzo
• Kulakalaka kudya
• Kulemera (mosachita mwadala) kuchokera pakusungidwa kwamadzimadzi
• Kugwidwa

Wothandizira zaumoyo adzayesa. Kuyeza kwa labotale kudzachitika kuti aone momwe impso zikuyendera. Zikuphatikizapo:

• Kuyesa magazi kwa Albumin
• Mayeso am'magazi am'magazi, monga gawo loyambira lamagetsi kapena gulu lamagetsi
• Magazi urea asafe (BUN)
• Creatinine - kuyesa magazi
• Chilolezo cha Creatinine - kuyesa mkodzo
• Kupenda kwamadzi

Mafuta nthawi zambiri amakhalanso mkodzo. Magazi a cholesterol ndi triglyceride atha kukhala okwera.

Kafukufuku wa impso angafunike kuti apeze chomwe chimayambitsa matendawa.

Kuyesa kuthana ndi zifukwa zosiyanasiyana kungaphatikizepo izi:

• Antinuclear antibody
• Cryoglobulins
• Malizitsani milingo
• Mayeso a kulolerana kwa glucose
• Matenda a hepatitis B ndi C
• Kuyezetsa HIV
• Chifuwa cha nyamakazi
• Seramu mapuloteni electrophoresis (SPEP)
• Chizonono serology
• Mkodzo mapuloteni electrophoresis (UPEP)

Matendawa amathanso kusintha zotsatira za mayeso otsatirawa:

• Mulingo wa Vitamini D
• Chitsulo cha seramu
• Kuponya kwamikodzo

Zolinga zamankhwala ndikuchotsa zizindikilo, kupewa zovuta, ndikuchepetsa kuwonongeka kwa impso. Kuti muchepetse matenda a nephrotic, matenda omwe amayambitsa matendawa ayenera kuthandizidwa. Mungafunike chithandizo chamoyo wonse.

Chithandizo chitha kuphatikizira izi:

• Kusunga kuthamanga kwa magazi pansi kapena pansi pa 130/80 mm Hg kuti muchepetse kuwonongeka kwa impso. Angiotensin-converting enzyme (ACE) inhibitors kapena angiotensin receptor blockers (ARBs) ndi mankhwala omwe amagwiritsidwa ntchito nthawi zambiri. ACE inhibitors ndi ma ARB amathanso kuthandizira kuchepetsa kuchuluka kwa mapuloteni omwe amatayika mkodzo.
• Corticosteroids ndi mankhwala ena omwe amalepheretsa kapena kuchepetsa chitetezo cha mthupi.
• Kuchiza cholesterol yambiri kuti muchepetse mavuto amtima ndi chotengera chamagazi - Chakudya chochepa kwambiri chamafuta chambiri sichimakhala chokwanira kwa anthu omwe ali ndi matenda a nephrotic. Mankhwala ochepetsa cholesterol ndi triglycerides (nthawi zambiri ma statins) angafunike.
• Chakudya chochepa kwambiri cha sodium chingathandize kutupa m'manja ndi m'miyendo. Mapiritsi amadzi (okodzetsa) amathanso kuthandizira vutoli.
• Zakudya zopanda mapuloteni ochepa zitha kukhala zothandiza. Omwe amakupatsirani anganene kuti azidya zakudya zochepa zomanga thupi (1 gramu ya protein pa kilogalamu ya kulemera kwa thupi patsiku).
• Kutenga zowonjezera mavitamini D ngati nephrotic syndrome ndi yayitali ndipo sakuyankha chithandizo.
• Kutenga mankhwala ochepetsa magazi kuti muchepetse kapena kuundana kwamagazi.

Zotsatira zimasiyanasiyana. Anthu ena amachira chifukwa cha vutoli. Ena amakhala ndi matenda a impso a nthawi yayitali ndipo amafunikira dialysis ndipo pamapeto pake amaikidwa impso.

Mavuto azaumoyo omwe angabwere chifukwa cha nephrotic syndrome ndi awa:

• Pachimake impso kulephera
• Kuuma kwa mitsempha ndi matenda amtima ofanana
• Matenda a impso
• Kuchulukanso kwamadzimadzi, kulephera kwa mtima, kuchuluka kwamadzi m'mapapu
• Matenda, kuphatikizapo chibayo cha pneumococcal
• Kusowa zakudya m'thupi
• Aimpso mtsempha thrombosis

Itanani omwe akukuthandizani ngati:

• Inu kapena mwana wanu mumakhala ndi matenda a nephrotic, kuphatikiza kutupa nkhope, mimba, mikono kapena miyendo, kapena zilonda za khungu
• Inu kapena mwana wanu mukulandira matenda a nephrotic, koma zizindikilo sizikula
• Zizindikiro zatsopano zimayamba, kuphatikizapo kutsokomola, kuchepa kwa mkodzo, kusasangalala ndi kukodza, malungo, kupweteka mutu

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati mukugwidwa.

Kuchiza zomwe zingayambitse matenda a nephrotic kungathandize kupewa matendawa.

Nephrosis

• Matenda a impso

Matenda a Erkan E. Nephrotic. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 545.

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.