'Kurapa' kurapwa kwehutano hwepfungwa kunogona kuchinja
Kunze kwekuva dambudziko guru rechirwere chepfungwa, kurohwa, nezvimwewo, kuwedzerwa kweropa kunogona kutungamirira kune zvirwere zvepfungwa . Kwete chete izvozvo, varwere vane chirwere chinorwara chepora (CKD), vari pangozi yakawanda yekufambira mberi kusvika pakupedzisira-chirwere chepfungwa chepfungwa (apo pavanenge vachida dialysis kana kuti kuchinja kwepvo), kana ropa ravo richiramba rakakwirira / risina kudzora.
Mushure mekushaya chirwere cheshuga, kukonzerwa kwehuwandu kweropa ndicho chikonzero chinowanzovhiringidza kuti vanhu vanokura kushaya mafungiro .
Kusiyanisa Pakati Pose Kusakwana Kwepempi uye Kuonda Kwirwere
Mukufamba kwenguva, kubudirira nekuchengetedza "chinokonzerwa neropa" ndeimwe yezvinokosha zvekudzivirira kuenderera kweCKD. Zvinogona kukudzivirira kubva pakugona kusvika kusvika pakasvika kwaunenge uine dialysis-zvinovimba. Asi chii icho chinonzi chinangwa cheropa?
Nzira Iyo Tinoita Kutambudzika Kweropa Haisi Dambudziko Rokufunga Kwechimwe Chiremba
Zvakanaka, kwete nguva dzose! Ichokwadi chagadziriswa neboka revanachiremba vakangwara vanogara vakakomberedza tafura, tarisa huri huno humwe humwe humwe uchapupu, uye taudza isu tose kuti tinofanira kuita sei! Iyo iboka rinonzi Joint National Committee (JNC) uye rinogadzwa neNational Institutes of Health (NIH). Nhengo yavo yemazuva ano yakakosha yakabuda munaFebruary 2014, uye inowanzotaurwa nezve "JNC 8." Ndiyo JNC iyo inowanzova neshoko rekupedzisira pane kwete chete mishonga yatinofanira kushandisa kurapa kukwirira kweropa, asiwo icho chinangwa chedu chinokonzerwa neropa rinofanira kuva.
Chikonzero nei Chinangwa Chinotarisana Neropa Chichichinja
Pakawanda, pamberi peJNC 8, taifarira kuva nehasha pamusoro pezvinangwa zvekurapa ropa, kazhinji kurapa varwere kune zvinangwa pasi pe 130/80. Zvisinei, kungoita kuti zvinhu zvivhiringidze, regai nditaure kuti JNC haisi yega yega yehurumende inopa mazano pamusoro pehupfumi hwekutonga ropa.
Tarisa Tarisi 6 apa.
Iwe unogona kuona kuti mazano ekutanga kubva munharaunda yegore ra2010-2011 uye asati aita seanokurudzira kudzvinyirira kuwedzerwa kwemazipa ekuderedza ropa. Izvozvo, chaizvoizvo, yaiva evhangeri yevhangeri yakagamuchirwa kune vakawanda vekuchiremba vanachiremba, cardiologists, uye nephrologists, kusvika munguva pfupi. Zvisinei, muna 2010 tine chidzidzo chikuru chekuwedzera kweropa iro rakataurwa mumapeji akacheneswa eNew England Journal of Medicine (NEJM). Ichi chidzidzo chakanzi ACCORD trial yakaratidza kuti pakanga pasina kubatsirwa kurapa kukwirira kweropa kune imwe yechisimba ye systolic 120 mm pamwe nekusununguka kunangwa kwe 140 mm. Izvi zvakamhanya mukutarisana kwe "kugamuchira" huchenjeri muhutano hwevanhu vezvehutano, izvo zvaiwanzotenda kuti kuderera kwemuviri weropa nguva dzose kwakanaka uye kwakakwirira kwakaipa! Uyu muedzo waiva, zvisinei, kwete paya mupani, kubva pakutanga, taona chimwe chidzidzo chichitaura chiitiko cheUVEST icho chakashumawo kuti hapana kubatsirwa kwekuita ropa reropa zvakanyanya.
(Ndinoda kuisa pachena kunyange zvakadaro semamwe mune imwe mishonga yemishonga, kurapwa kwehutano kwepamusoro kune imwe nzvimbo yekukakavara kukuru uye zvinhu zvinoramba zvichinja. Hapana miviri miviri inoita seinobvumirana uye kunyange JNC yakagamuchira mugove wayo wakanaka webhari ).
Current Treatment Targets
JNC inonyanya kurudzira zvinangwa zvichienderana nezera rehuwandu hwevanhu:
- Zera <60 yrs: chinangwa ndechokudzichengeta pasi pe 140/90
- Zera> 60 yrs: chinangwa ndechekuti uchengetedze pasi pe 150/90
Zvinangwa Zvakasiyana Nevanhu vane Kidney Disease
Ropa zvinokonzerwa nehupfumi zvinoshandiswa kune munhu akawandisa ane huwandu hwehutachiona hunogona kusashanda kumushandi wehutachiona uyo ane chirwere chepfungwa . Kutaura zvazviri, tine mamwe masangano anonyatsopinda nezvirwere zvepfungwa zvakadai seDhinney Disease Improving Global Outcomes (KDIGO) dzakakurudzira zvinangwa zvekurapa zvishoma. Asi kusvika kune JNC 8 inopinda, chinangwa ndechekuti munhu wose aine zvirwere zvepfungwa, pasinei nezera rinoparidzirwa kuropa remuviri <140/90.
Uye iwe haufaniri kudiwa kurapwa kana uchida kugara pasi pezinga iri pavhareji. Kana iwe uri pedyo nenhamba iyi, unogona kurega nekudya / mararamiro ekuchinja iwe oga.
Izvo Zvakare Nezvokuita Kwaunoita
Izvo zvandakatsanangura pamusoro apa ndezvipi zvinokonzera BP kune. Asi mumwe chiremba-kusvika-zuva acharamba achifunga mupfungwa ipi yemishonga inoshandiswa kukuita iwe kuchinangwa. Kuguma hakurevi nguva dzose zvinorehwa nehutano hwehutano . Handizopindi mazano ayo pano asi iwe unogona kupfuura nemashoko eJNC 8 kana iwe uchida kuziva.
Isu tinowanzovawo chimwe chinhu chinonzi "zviratidzo zvinomanikidzira" kana zvichiitika mukurapa kwehutano. Somuenzaniso, mumwe munhu ane zvakawanda zvakakwana zveprotini mumuginhi anogona kuiswa paisinopril (ropa repiritsi piritsi), kunyange kana ropa riri pasi pechinangwa ichi. Munyaya iyi, ropa repiritsi rinoshandiswa kune zvimwe zviratidzo.
Kutaura muchidimbu, kune vakawanda varwere vane chirwere chepfungwa, chinangwa chinangwa chekuita kuti kuwedzerwa mafungiro epfungwa uye kuderedze mikana yavo yekufambira mberi kusvika pakupedzisira-chirwere chepfungwa chinenge chiri <140/90. Ikoko ndiko kwatinomira kusvikira JNC 9!