Yini i-Nephrologist ne-Where Should You See One?
Ama-Nephrologists bangodokotela abasebenza ngokukhethekile ekuxilongweni nasekwelapheni isifo sezinso. Iziphi izimo eziphathwa ngudokotela wezinso, futhi ukudluliselwa komunye walabachwepheshe kuyadingeka nini?
Ukuhlolwa Okubalulekile Kwezinso
Uma ungazange uzwe nge-nephrology (isifundo sezinso zezinso) ngaphambili, akumangalisi. Isifo sezinso ezingapheli (CKD) ngokuvamile sibizwa ngokuthi "umbulali othulile," njengoba abantu abaningi banampawu ezincane noma azikho izimpawu lapho bexilongwa.
Kunemigomo eminingi ehlukene engasetshenziselwa ukuchaza isifo sezinso esingangezela ekudidekeni. Njengoba kuphawuliwe ngenhla, amaNeprologists bangodokotela abaphatha isifo sezinso, negama lesiGreki elithi "nephros" elisho izinso. Ungase uzwe isifo se-renal esetshenziswa ukuchaza izinkinga zezinso. I-term renal ivela emthonjeni weLatini "renes" okusho nezinso.
Yiziphi izinhlobo zezokwelapha ezingathinta izinso zakho, yiziphi ezinye zezibonakaliso ezivamile, futhi uma kufanele uthunyelwe ku-nephrologist? Ucwaningo lubonisa ukuthi ukubambezela ukuvakashela isazi sezinkanyezi kungandisa ingozi yezinkinga noma ukufa, ngakho lo ngumbuzo obalulekile.
Izimo Eziphathwa NgamaDokotela Wezinso (amaNeprologists)
Odokotela bezinso banakekela abantu abanezinhlobo ezahlukene zezifo zezinso ezibandakanya:
- Ukulimala okusobala kwezinso: Isifo esiphezulu sezinso sibhekisela ekufuseni ngokushesha kwezinso zezinso ngokuvamile ezihlobene nezimo ezifana nokushaqeka (ukunciphisa igazi ukumiswa kwezinso), ukuphuma kwamanzi noma izinkinga zezinso ezihlobene nokuhlinzwa
- Ukwehluleka kokuqeda izinsola: Isifo esingapheli sezinso singabangelwa izimo eziningi ezahlukene (bheka ngezansi)
- Amatshe ezinso : Kunezinhlobo ezahlukene zamatshe ezinso okungenzeka noma ezingabangeli izimpawu
- Ukutheleleka kwezinso (pyelonephritis): Igama elithi "ukutheleleka kwamagciwane" libhekisela ezimweni eziningi ezivela kubhaktheriya emcinini, ukuya ezifweni zesifo sofuba, ukutheleleka kwezinso ( pyelonephritis )
Kunezinkinga ezahlukene zezokwelapha ezingathinta izinso ngezindlela ezahlukene. Ezinye zezimo ezivame kakhulu ezingabangela ukwehluleka kwezinso zihlanganisa:
- Isifo sikashukela (i- nephropathy yesifo sikashukela ): Isifo sikashukela siyimbangela ebangela ukuhluleka kwezinso e-United States
- Isifo sezinso esihlobene nomfutho wegazi ophezulu nesifo senhliziyo ( cardiorenal syndrome )
- Ukukhuluphala
- Ukwelashwa kwezinso ezingapheli
- Amatshe ezinso ezibangelwa ukuvinjelwa
- Ukuzalwa kwangasese (kusukela ekuzalweni) izinkinga zezinso njengezinso zehhashi
- I-Glomerulonephritis: I-Glomerulonephritis ukuvuvukala kwezinso ezingabangelwa izinqubo eziningi ezihlukene, kufaka phakathi amabhaktheriya abangela i-strep throat.
- Isifo sezinso esihlobene ne-lupus ( lupus nephritis )
- Isifo sezinso zePolycystic: Isifo sezinso zesifo senhliziyo sinezifa, nakuba ubuhlungu besifo, kanye nokuqala kokuqala, kungahluka
- Izifo ezizenzakalelayo ezifana ne-igA nephropathy
- Ukuhluleka kwezinso kwesifo sesibindi ( hepatorenal syndrome )
Isifo sezinso ezingapheli sichazwa ngezigaba ezingu-5 esekelwe ebucayi besifo. Ukuhluleka kwezinso zeBanga 1 kubhekisela ezifweni ezincane, kanti ukuhluleka kweqhwa lesi-grade 5 kubonisa ukuthi i-dialysis noma ukufakelwa kwezinso kuyodingeka.
Ngaphezu kokulawulwa kwezinkinga zezinso (ukuzama ukulungisa isimo noma ukuvimbela ukuthi singabe sibheka), odokotela bezinso baphatha izimpawu ezivame ukuhambisana nezifo zezinso, ezifana nokuphazanyiswa kwe-electrolyte (ikakhulukazi izinkinga ngamazinga e-potassium) nokucindezela kwegazi eliphezulu.
Izimpawu Zesifo Sezinso
Ukuze uqonde izimpawu ezivamile zesifo sezinso, kuyasiza ukubuyekezwa isakhiwo nomsebenzi wezinso . Izinso zakho zisezintanjeni zakho, eduze nomgogodla wakho. Ukulimala emhlane wakho noma ohlangothini olungezansi kwe-diaphragm yakho kungabangela ukulimala izinso zakho. Izinso zakho zenza imisebenzi eminingana ebalulekile. Lokhu kufaka phakathi ukuhlunga igazi lakho ukususa ubuthi, ukugcina amazinga afanele we-electrolyte (njenge-sodium ne-potassium) ukuqinisekisa ukusebenza kahle kwamaseli akho, nokugcina ukulinganisela kwamanzi emzimbeni wakho.
Uma uchitheka amanzi, izinso zakho ekuqaleni zisebenza ukubuyisela isimo somzimba emzimbeni wakho, kepha ukulimala kwezinso kungenzeka ngokuphela kwamanzi okwesikhashana noma okunzima. Uma izinso zakho zingasebenzi ngendlela efanele, izinga le-sodium ne-potassium emzimbeni wakho lingathinteka. Izinkinga ze-electrolyte ezinesifo sezinso zingaba sína, Njengoba inani elifanele le-potassium liyadingeka ukuze kusetshenziswe kahle kwenhliziyo yakho, izinkinga zezinso zingabangela izilinganiso ezingavamile zenhliziyo.
Ukucindezeleka okungavamile kwegazi, kungakhathaliseki ukuthi okuphakeme noma okuphansi kungabangela ukulimala kwezinso. Ukulimala kwezinso, nakho kungabangela izinkinga ekulawuleni umfutho wegazi lakho.
Izinso nazo zibophezele ekwenzeni ihomoni ehilelekile ekukhiqizeni amaseli abomvu egazi. Ngenxa yalesi sizathu, isifo sezinso singabangela i- anemia , inani elincane elibomvu lamasosha egazi.
Abanye abantu banezinkinga ze-urinary, njengokunzima ukuchama. Ngezinye izikhathi abantu banesifo senhliziyo, ngenxa yendawo yezinso. Amatshe ezinso angase azwakalise ubuhlungu obunzima obufaniswe nokubeletha kepha kungaba khona ngaphandle kobuhlungu.
Izimpawu ezingacacile noma ezingacacile zivamile, futhi kungani kufanele ubone udokotela wakho noma ngabe awukwazi ukubona kahle izimpawu zakho. Lokhu kungafaka ukukhathala, ukuleleka, noma ukunambitheka kwe-metal emlonyeni wakho.
Ekuqaleni ngezinso zezinso, futhi ngezinye izikhathi ngisho nesifo sezinso esiphezulu, abantu bangase babe nezimpawu ezimbalwa. Eqinisweni, uphawu oluvame kakhulu lwesifo sezinso alukho izimpawu nakancane !
Ukuqaphela Izifo Zezinso
Kunezinhlobo ezahlukene zokuhlolwa ezingenziwa ukuze zibuke futhi zilandele izinkinga zezinso. Lokhu kuhlanganisa ukuhlolwa kwegazi (njenge- BUN (i-blood urea nitrogen), i-cr (creatinine), ne-GFR (izinga lokuhlunga kwe-glomerular)), izivivinyo zomchamo (ikakhulukazi zifuna i- proteinuria ), nokuhlolwa kwe-imaging njenge-CT, MRI, ne-IVP.
Isikhathi Esihle Sokubona Umlobi Wezinkanyezi
Isikhathi esingcono kakhulu ukubona isazi sezinkanyezi ngokuqinisekile singahlukahluka kuye ngezimo zakho ezithile. Lokho kusho ukuthi kufanele ubonwe yi-nephrologist uma i-creatinine yakho isiphezulu ngokwanele ukuze kuthiwa yi-CKD Stage 4. Lokhu kungasho ukuthi i-GFR engaphansi kuka-30.
Ukubaluleka kokubhekwa kumuntu we-Nephrologist
Angikugcizelele ukubaluleka kokudluliselwa ku-nephrologist ngoba ngingomunye. Eqinisweni, izifundo eziningi zezokwelapha ziye zabonisa ngokucacile ukuthi iziguli ezibhekiswe emuva ngasezintweni ze-nephrologists zingase zife, noma ziqhubekele ku-dialysis!
Izingozi Zezifo Zezinso
Njengoba isifo sezinso singabi sína ngaphambi kokuba izimpawu zikhona, kubalulekile ukuba nenhlamba ephezulu yokusola futhi uqaphele izimo ezikubeka ekufeni kwesifo sezinso. Abantu abasengozini enkulu yokuthuthukisa ukwehluleka kwenhlamba kubandakanya labo abane:
- Isifo sikashukela
- Ukuma kwe-high high blood pressure
- Izifo zenhliziyo ezifana nesifo se-coronary artery, noma ukuhluleka kwenhliziyo yokugcoba
- Ezinye izifo ze-vascular ezifana nesifo sofuba (iziphazamiso) nezifo zesifo se-peripheral (njenge-aneorysms aortic)
- Umlando womndeni wezifo zezinso
- Ukusetshenziswa isikhathi eside kwezidakamizwa ezingezona ukuvuvukala (i-NSAIDS) njenge-Advil (ibuprofen) ne-Celebrex
Ukwelapha
Izindlela zokwelashwa kwezinso zezinso ziyahlukahluka ngokuyinhloko ngokususelwa ekubambeni. Lapho umsebenzi wezinso unciphisa kakhulu umuntu angadinga i- dialysis yokuhluleka kwezinso noma ukufakelwa kwezinso.
Ukuba Ummeli Wakho Ngezinso Zakho
Uma kuziwa ngesifo sezinso, ukutakula ngokuvamile akukenzeki uma i-GFR yakho isenqatshelwe izigaba eziphambili. Ngakho-ke, kugcizelelwa ngempela kudingeke ukuba kuvikelwe. Esikhathini esilandelayo lapho uzobona udokotela wakho eqinisekisa ukuthi uzoxoxa ngemiphumela ye-GFR yakho bese ubuza ukuthi kufanele ubonwe ngumchwepheshe.
Ngezansi Ngesikhathi Sokubona Udokotela Wezinso
Isikhathi esingcono kakhulu sokubona udokotela wezinso kuzohluka ngokusekelwe emsebenzini wakho wezinso, isimo esithile sokuqhwaba onakho, nezinye izinto eziyingozi. Kubonakala sengathi ukudluliselwa kokubona isazi sezinzwa kufanele kubhekwe njengeCr ephakeme (isigaba 4) noma i-GFR engaphansi kuka-30, kodwa abanye abantu kufanele babone udokotela wezinso ngokushesha. Njengoba ukubonisana ngesikhathi esifanele ne-nephrologist kuqhathaniswa nokusinda, kungcono ukuphutha eceleni kokubona omunye waladokotela ngaphambili kunokuba kamuva.
> Imithombo:
> Kim, D., Kim, M, Kim, H. et al. Ukudluliselwa kokuqala kumuntu we-Nephrologist Ukuphulukiswa Kwamapulangwe Okuphuthumayo: Isifundo Esihambelana NamaKhosi Ukufunda Izifo Zokuqeda Izintambo eKorea. PLoS One . 2013. 8 (1): e55323.
> Smart, N., Dieberg, G., Ladhani, M., noT. Titus. Ukudluliselwa Kokuqala Kwengcweti Yezinsizakalo ze-Nephrology zokuvimbela ukuqhubekela phambili ekupheleni kwesifo sezinso. I-Cochrane Database Yezobuchwepheshe Ezihleliwe . 2014. (6): CD007333.
> Smart, N., noT. Titus. Imiphumela ye-Nephrology Early Referral ku-Chronicle Referral in Chronic Suver's Disease: Ukubuyekeza Okuhlelekile. I-American Journal of Medicine . 2011. 124 (11): 1073-80.e2.