Impso zamatenda apakati

Distal renal tubular acidosis ndi matenda omwe amapezeka pamene impso sizimachotsa bwino zidulo m'magazi mumkodzo. Zotsatira zake, asidi wambiri amakhalabe m'magazi (otchedwa acidosis).

Thupi likagwira ntchito zake zonse, limatulutsa asidi. Asidiyu akapanda kuchotsedwa kapena kuthetsedwa, magaziwo amakhala acidic kwambiri. Izi zitha kubweretsa kusamvana kwama electrolyte m'magazi. Zingathenso kuyambitsa mavuto ndi magwiridwe antchito am'maselo ena.

Impso zimathandiza kuchepetsa asidi m'thupi pochotsa asidi m'magazi ndikuwatulutsa mumkodzo.

Distal renal tubular acidosis (mtundu I RTA) imayambitsidwa ndi chilema m'machubu ya impso chomwe chimayambitsa asidi kukhala m'magazi.

Type I RTA imayambitsidwa ndimikhalidwe yosiyanasiyana, kuphatikiza:

• Amyloidosis, mapuloteni ambiri, omwe amatchedwa amyloid, m'matumba ndi ziwalo
• Matenda a Fabry, omwe amakhala modabwitsa mthupi la mtundu wina wamafuta
• Mulingo wambiri wa calcium m'magazi
• Matenda a Sickle cell, maselo ofiira ofiira omwe nthawi zambiri amawoneka ngati diski amatenga chikwakwa kapena mawonekedwe a kachigawo
• Matenda a Sjögren, matenda omwe amachititsa kuti misozi ndi misozi ziwonongeke
• Systemic lupus erythematosus, matenda omwe amangodziyimitsa okha omwe chitetezo chamthupi chimalakwitsa molakwika minofu yathanzi
• Matenda a Wilson, matenda obadwa nawo momwe mumakhala mkuwa wochuluka mthupi la munthu
• Kugwiritsa ntchito mankhwala ena, monga amphotericin B, lithiamu, ndi analgesics

Zizindikiro za distal renal tubular acidosis ndi izi:

• Kusokonezeka kapena kuchepa kukhala tcheru
• Kutopa
• Kulephera kukula kwa ana
• Kuchuluka kwa kupuma
• Miyala ya impso
• Nephrocalcinosis (kashiamu wambiri amene amaikidwa mu impso)
• Osteomalacia (kuchepetsa mafupa)
• Minofu kufooka

Zizindikiro zina zitha kuphatikiza:

• Kupweteka kwa mafupa
• Kuchepetsa mkodzo
• Kuchuluka kwa kugunda kwa mtima kapena kugunda kwamtima kosasinthasintha
• Kupweteka kwa minofu
• Ululu kumbuyo, pambali, kapena pamimba
• Zovuta zamafupa

Wothandizira zaumoyo adzakuyesani ndikufunsani za matenda anu.

Mayeso omwe atha kulamulidwa ndi awa:

• Magazi amitsempha yamagazi
• Magazi amadzimadzi
• Mkodzo pH
• Mayeso a acid-katundu
• Kuyesa kulowetsedwa kwa Bicarbonate
• Kupenda kwamadzi

Ma calcium omwe amapezeka mu impso ndi miyala ya impso amatha kuwona:

• X-ray
• Ultrasound
• Kujambula kwa CT

Cholinga ndikubwezeretsa mulingo wabwinobwino wa asidi komanso kuchuluka kwa ma electrolyte mthupi. Izi zithandizira kukonza kusokonezeka kwa mafupa ndikuchepetsa calcium mu impso (nephrocalcinosis) ndi miyala ya impso.

Chimene chimayambitsa distal renal tubular acidosis chikuyenera kukonzedwa ngati chingadziwike.

Mankhwala omwe angaperekedwe ndi monga potaziyamu citrate, sodium bicarbonate, ndi thiazide diuretics. Awa ndi mankhwala amchere omwe amathandizira kukonza acidic ya thupi. Sodium bicarbonate ikhoza kukonza kutayika kwa potaziyamu ndi calcium.

Matendawa ayenera kuthandizidwa kuti achepetse zovuta zake, zomwe zitha kukhala zowopsa kapena zowopsa pamoyo. Nthawi zambiri amachira.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo za distal renal tubular acidosis.

Pezani chithandizo chamankhwala nthawi yomweyo mukakhala ndi zadzidzidzi monga:

• Kuchepetsa chidziwitso
• Kugwidwa
• Kutsika kwakukulu pakuchenjeza kapena kumayang'ana

Palibe njira yothetsera vutoli.

Aimpso tubular acidosis - distal; Aimpso tubular acidosis mtundu I; Lembani I RTA; RTA - distal; Zachikhalidwe RTA

• Matenda a impso
• Impso - kutuluka magazi ndi mkodzo

Bushinsky DA. Miyala ya impso. Mu: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: chap 32.

Dixon BP. Aimpso tubular acidosis. 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 547.

Seifter JL. Mavuto amadzimadzi. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 110.