Matenda omaliza a impso

Matenda a impso otsiriza (ESKD) ndiye gawo lomaliza la matenda a impso a nthawi yayitali (osatha). Apa ndi pamene impso zanu sizingathenso kuthandizira zosowa za thupi lanu.

Matenda a impso otsiriza amatchedwanso matenda a impso (ESRD).

Impso zimachotsa zinyalala ndi madzi ochulukirapo m'thupi. ESRD imachitika pamene impso sizingathenso kugwira ntchito pamlingo wofunikira pamoyo watsiku ndi tsiku.

Zomwe zimayambitsa ESRD ku United States ndi matenda ashuga komanso kuthamanga kwa magazi. Izi zitha kukhudza impso zanu.

ESRD nthawi zambiri imabwera pambuyo pa matenda a impso. Impso zimatha kusiya kugwira ntchito pakadutsa zaka 10 mpaka 20 matenda asanakwane.

Zizindikiro zodziwika zimaphatikizapo:

• Kumva kuwawa komanso kutopa
• Kuyabwa (pruritus) ndi khungu louma
• Mutu
• Kuchepetsa thupi osayesa
• Kutaya njala
• Nseru

Zizindikiro zina zitha kuphatikiza:

• Khungu lodera kapena lowala modabwitsa
• Zosintha za msomali
• Kupweteka kwa mafupa
• Kugona ndi kusokonezeka
• Mavuto okhazikika kapena kuganiza
• Kunjenjemera m'manja, mapazi, kapena madera ena
• Minofu kugwedezeka kapena kukokana
• Fungo la mpweya
• Kuvulaza kosavuta, kutulutsa magazi m'mphuno, kapena magazi mu chopondapo
• Ludzu lokwanira
• Ma hiccups pafupipafupi
• Mavuto ndi magwiridwe antchito
• Kusamba kumasiya (amenorrhea)
• Mavuto ogona
• Kutupa kwa mapazi ndi manja (edema)
• Kusanza, nthawi zambiri m'mawa

Wothandizira zaumoyo wanu adzayezetsa thupi ndikuwayesa magazi. Anthu ambiri omwe ali ndi vutoli ali ndi kuthamanga kwa magazi.

Anthu omwe ali ndi ESRD amachepetsa mkodzo, kapena impso zawo sizipanganso mkodzo.

ESRD amasintha zotsatira zamayeso ambiri. Anthu omwe alandira dialysis adzafunika mayesero awa ndi ena nthawi zambiri:

• Potaziyamu
• Sodium
• Albumin
• Phosphorous
• Calcium
• Cholesterol
• Mankhwala enaake a
• Kuwerengera kwathunthu kwa magazi (CBC)
• Maelekitirodi

Matendawa amathanso kusintha zotsatira za mayeso otsatirawa:

• Vitamini D.
• Mahomoni a Parathyroid
• Kuyesa kachulukidwe ka mafupa

ESRD ingafunike kuthandizidwa ndi dialysis kapena impso kumuika. Muyenera kukhala ndi chakudya chapadera kapena kumwa mankhwala kuti muthandize thupi lanu kugwira ntchito bwino.

KUFUFUZA

Dialysis imagwira ntchito ya impso zikaleka kugwira bwino ntchito.

Dialysis ikhoza:

• Chotsani mchere, madzi, ndi zinthu zina zotayidwa kuti zisakule mthupi lanu
• Muzisunga mchere ndi mavitamini mthupi lanu
• Thandizani kuchepetsa kuthamanga kwa magazi
• Thandizani thupi kupanga maselo ofiira a magazi

Wopereka wanu amakambirana za dialysis nanu musanayifune. Dialysis imachotsa zonyansa m'magazi anu pomwe impso zanu sizingagwire ntchito yawo.

• Nthawi zambiri, mumapita pa dialysis mukangotsala ndi 10% mpaka 15% ya ntchito yanu ya impso.
• Ngakhale anthu omwe akudikirira impso angafunike dialysis podikirira.

Njira ziwiri zosiyanasiyana zimagwiritsidwa ntchito pochita dialysis:

• Mukamayesa kuchepa magazi, magazi anu amadutsa mu chubu kulowa mu impso, kapena zosefera. Njirayi imatha kuchitika kunyumba kapena kuchipatala.
• Pakati pa peritoneal dialysis, yankho lapadera limadutsa m'mimba mwanu ngakhale chubu la catheter. Yankho limakhala m'mimba mwanu kwakanthawi kenako limachotsedwa. Njirayi imatha kuchitika kunyumba, kuntchito, kapena poyenda.

KUSAMBA MAFUPA

Kuika impso ndiko kuchita opaleshoni kuti muike impso yathanzi mwa munthu amene walephera impso. Dokotala wanu adzakutumizirani kuchipatala. Kumeneko, mudzawonedwa ndikuyesedwa ndi gulu losindikiza. Afuna kuwonetsetsa kuti ndinu woyenera kupatsirana impso.

Zakudya Zapadera

Mungafunike kupitiriza kudya zakudya zapadera za matenda a impso. Zakudyazo zimatha kuphatikiza:

• Kudya zakudya zopanda mapuloteni
• Kupeza mafuta okwanira ngati mukuchepetsa thupi
• Kuchepetsa madzi
• Kuchepetsa mchere, potaziyamu, phosphorous, ndi ma electrolyte ena

CHithandizo CHINA

Mankhwala ena amatengera zizindikiro zanu, koma atha kukhala:

• Calcium yowonjezera ndi vitamini D. (Nthawi zonse lankhulani ndi omwe amakupatsani musanadye zowonjezera.)
• Mankhwala otchedwa phosphate binders, kuti athandize kupewa kuchuluka kwa phosphorous kuti likhale lokwera kwambiri.
• Chithandizo cha kuchepa kwa magazi m'thupi, monga chitsulo chowonjezera mu zakudya, mapiritsi achitsulo kapena kuwombera, kuwombera kwa mankhwala otchedwa erythropoietin, ndi kuthiridwa magazi.
• Mankhwala ochepetsa kuthamanga kwa magazi.

Lankhulani ndi omwe amakupatsani za katemera omwe mungafune, kuphatikizapo:

• Katemera wa hepatitis A.
• Katemera wa Hepatitis B
• Katemera wa chimfine
• Katemera wa chibayo (PPV)

Anthu ena atha kupindula kutenga nawo mbali pagulu lothandizira matenda a impso.

Matenda omaliza a impso amatsogolera kuimfa ngati mulibe dialysis kapena impso. Mankhwalawa onse ali ndi zoopsa. Zotsatira zake ndizosiyana ndi munthu aliyense.

Mavuto azaumoyo omwe angabwere kuchokera ku ESRD ndi awa:

• Kuchepa kwa magazi m'thupi
• Kutuluka magazi m'mimba kapena m'matumbo
• Kupweteka kwa mafupa, olowa, ndi minofu
• Kusintha kwa shuga wamagazi (shuga)
• Kuwonongeka kwa mitsempha ya miyendo ndi mikono
• Kutulutsa kwamadzi kuzungulira mapapo
• Kuthamanga kwa magazi, matenda a mtima, ndi kulephera kwa mtima
• Mlingo waukulu wa potaziyamu
• Kuchulukitsa chiwopsezo cha matenda
• Kuwonongeka kwa chiwindi kapena kulephera
• Kusowa zakudya m'thupi
• Kupita padera kapena kusabereka
• Matenda opanda miyendo
• Stroke, khunyu, ndi dementia
• Kutupa ndi edema
• Kuchepetsa mafupa ndi ma fracture okhudzana ndi phosphorous kwambiri ndi calcium yotsika kwambiri

Aimpso kulephera - siteji yotsiriza; Impso kulephera - siteji yotsiriza; ESRD; ESKD

• Matenda a impso
• Glomerulus ndi nephron

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Inker LA, Levey AS. Staging ndi kasamalidwe ka matenda a impso. Mu: Gilbert SJ, Weiner DE, olemba., Eds. National Impso Foundation Primer pa Matenda a Impso. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 52.

Zolemba MW. Gawo ndi kasamalidwe ka matenda a impso. 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 59.

Yeun JY, Young B, Depner TA, Chin AA. Kuchepetsa magazi. 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 63.