Kune rumwe rutivi kana rumwe rutivi, nhengo dzomuviri wose dzakabatana-basa rinowanzoshandiswa nhengo imwechete rinotsigira pane imwe dhigirii pamusoro pechiito chekushanda kwevamwe vose. Uku kudyidzana kunonyanya kuparadza pakati pemwoyo netsvo.
Izvo zvinowanzoshungurudza vanhu vane chirwere chemwoyo chakakura kuti pakupedzisira vave nekurwara kwenguva refu.
Izvo zvinowanzoonekwawo nevanhu vane zvirwere zvepfungwa kukudziridza chirwere chemwoyo. Izvi zvinoreva kuti vanhu vane dambudziko nemumwe wezvirongwa izvi zvemuviri vanofanira kuve vakangwarira (pamwe chete navanachiremba) kune mukana wekugadzirisa dambudziko kune imwe, uye kutora matanho anononoka ekuderedza dambudziko reizvi zvichiitika.
Ukama Pakati Pehutano hweMweya uye Dendase Dzaase
Chirwere chepfungwa uye zvirwere zvepfungwa zvinowanzoenda pamwechete. Nyanzvi dzakarondedzera nenzira shanu nzira iyo chirwere chepachiviri uye chirwere chetsitsi chinopindirana:
- Zvikamu zvakakosha zvepfungwa kukanganisa zvinogona kukonzera kuora kwakanyanya kwepvo.
- Kushushikana kwemoyo kusingaperi kunowanzoita kuti zvirwere zvisingaperi zvirwere .
- Kushanda kwepfungwa kunokonzerwa nokukurumidza kunogona kukonzera kushaya mwoyo kwakanyanya.
- Chirwere chepfungwa chinogara chichibatanidza nehuwandu hwehuwandu hwehutachiona hwehutano (CAD) , kukanganisa kwemwoyo , uye chironga chemwoyo .
- Zvinetso zvoutano zvakasiyana siyana zvinogona kukanganisa zvirongwa zvakawanda zvechirongwa, zvakadai sechirwere cheshuga kana lupus , kazhinji zvinounza zvirwere zvemoyo neminso.
Saka, kana mwoyo kana itsvo dzichibatwa nedzimwe chimiro chechirwere, kune ngozi yakakura yekuti imwe nhengo ichava nezvinetso zvezvechiremba. Iyi hukama hukuru pakati pavo dzimwe nguva yave ichinzi cardiorenal syndrome .
Hazvifananidzi kushamisika kuti kuva nechirwere muzvikamu zvose zvechirongwa chemuviri kwakaipa kudarika kuva nechirwere mune imwe chete.
Vanhu vane kusagadzikana kwemoyo kusingaperi avo vane zvirwere zvepfungwa vari pangozi yakakura yekufa kwekutanga. Uye pakati pevanhu vane chirwere chisingaperi chepfungwa, zvinetso zvepfungwa zvinoguma zvichikonzera rufu munenge hafu.
Kunyange zvazvo nzira dzakawanda umo chirwere chepfungwa chinogona kutungamirira kune zvirwere zvepfungwa, uye zvakasiyana-siyana, hazvisati zvanyatsonzwisiswa, mumakore achangopfuura kunzwisisa kwedu kwoukama uhwu kwawedzera zvikuru, zvichibatsira kuti tive nekugadzirisa matanho ekuderedza dambudziko reizvi zvichiitika.
Dambudziko reMwoyo Rinogona Kukonzera Matambudziko Apiyo
Kuora mwoyo kwemoyo ndiko kliniki iyo inogona kuguma kubva kune chero mapepa emwoyo. Kazhinji, apo chirwere chemwoyo chinokonzera chirwere chepfungwa, mwoyo kusakundikana kwave kuripo. Kune nzira dzakawanda umo kukanganisa kwemwoyo kunogona kutungamirira kune zvirwere zvepfungwa. Iyo huru ndeyokuti:
Drop in cardiac output. Mukusakundikana kwemoyo kusingaperi, muwandu weropa uri kuputirwa nemoyo unogona kuderedzwa. Izvi zvinogona kuita kuti kuderedzwa kwehuwandu weropa richisvibiswa neitsvo, izvo zvinokonzera renal basa kuti iwedzere.
Neurohumoral change . Kuti abatsire kudonha kwechibereko chemwoyo chinowanzoitika mumoyo kusakundikana, kuchinja kwakasiyana kunowanzoitika munzwirwe tsitsi yenheyo uye mune mahomoni anodzora ivhu remunyu nemvura mukuparadzirwa-ndiko kuti, mune renin-angiotensin- aldosterone system .
Iko kushandura kunoita kuti kuwedzerwa munyu uye kuchengetwa kwemvura, iyo munguva pfupi inogona kuvandudza kuwanda kweropa kunosvika nhengo dzinokosha. Zvisinei, munguva yakareba, izvi zvinoshandiswa neurohumoral zvinotungamirira kuodema (kukuputika) uye kunyange kuderedza kuderedza muhutano hwemwoyo. Saka, zvisingaperi, kuchinja uku kunoita kuti ropa riyerere kusvika kune itsvo, uye basa repvo rinotambura.
Kuwedzerwa kukurudzirwa mumavhenda ekudzivirira. Mwoyo wakakundikana, kupera kwemwoyo kunokonzera kukanganiswa mukati memawere. Kumanikidzika kwakakwirira mumapetanga emvura (mitsipa inodonha itsvo) inoita kuti zvive zvakaoma kuti itsvo dzifunge ropa.
Zvakare, renal function inowedzera.
Somugumisiro weizvi nedzimwe nzira, kusagadzikana kwepfungwa kusagadzikana kunokonzera kushungurudzika kune dzimwe itsvo dzinodzivirira kushanda kwavo kwemazuva ose, uye kuti, nokufamba kwenguva, zvinogona kukonzera kukuvadzwa zvachose kuitsvo.
Mafiro eDhiyabhorosi Anokonzera Matambudziko Emoyo
Kune rumwe rutivi, zvirwere zvepvo zvinowanzoita kuti matambudziko emwoyo. Inoita izvi nenzira mbiri huru.
Kutanga, chirwere chisingaperi chisinganzwisisi chinowanzobudisa munyu uye kuchengetedza mvura, izvo zvinogona kuisa dambudziko guru pamwoyo. Kana chero chirwere chepfungwa chepfungwa chiripo, kana chiri CAD, chirwere chemwoyo chinonzi valve ( cardiomyopathy) (mwoyo yemasurupa chirwere), kuwedzera uku mumuviri wemvura kunokonzera kukanganisa kwemoyo uye kunogona kukonzera kukanganisika kwemoyo.
Chechipiri, chirwere chisingaperi chisinganzwisisiki chinonyanya kukonzera kukwidziridzwa kweCAD, uye kukura kweCAD chero ipi zvayo inogona kuvapo. Vanhu vane chirwere chisingaperi chepfungwa vanewo CAD vane hutano hwakanyanya kuipa, uye zvinowedzera kuitika, kupfuura vanhu vane CAD vasina zvirwere zvepfungwa.
Dambudziko reHIV rinoperesa kazhinji rinotungamirira kuCAD
Pane zvikonzero zviviri zvinoita kuti vanhu vane zvirwere zvisingaperi zvepfungwa vane dambudziko guru rekudzidzira CAD.
Chimwe chinhu, zvidzidzo zvehuwandu zvakaratidza kuti vanhu vane zvirwere zvepfungwa zvisingagumi vanowanzova nehuwandu hwakawanda hwezviitiko zvinokonzera ngozi kune CAD. Izvi zvinosanganisira kusvuta, chirwere cheshuga, high cholesterol , hypertension , mararamiro ekugara, uye kukwegura.
Mukuwedzera, chirwere chisingaperi chepfungwa pachacho pachacho chinowedzera zvikuru ngozi yeCAD. Chirwere chepoyi chinowedzera dambudziko iri nenzira dzakasiyana-siyana. Semuenzaniso, iyo inonyadzisira inowanikwa muropa nekuda kwebasa rinenge risina kuchena (iyo inonzi inonzi uremic toxin) inowedzera dambudziko reCAD. Mamwe ropa uye kusagadzikana kwemagetsi kunobatanidza nehutachiona hwepfungwa zvekare zvinowedzerawo ngozi. Izvi zvinosanganisira kusagadzikana kwema calcium metabolism, anemia , chirwere chisingaperi chisingabvumi ( nemazinga akakwirira eCRP ), kudya kwakashata, uye mapuroteni emuropa akakwirira.
Zvakatorwa pamwechete, zvinhu izvi zvinoratidzika kuti zvinobereka endothelial kusagadzikana , chiitiko chakabatanidzwa neCAD nemamwe mamiriro ezvinhu emwoyo zvinosanganisira kuwedzera kwehutano, diastolic dysfunction , uye chirwere chemwoyo x .
Nzira Yokudzivirira Nayo Zvirwere Muviri Maviri
Nokuti chirwere chepfungwa uye zvirwere zvepfungwa zvinowanzoungana pamwe chete, ani naani ane dambudziko neimwe yezvirongwa izvi zvegomu anofanira kushanda nevarapi vavo kudzivirira zvirwere kubva kuitika kune imwe.
Chirwere chemoyo. Kana iwe uine chirwere chepfungwa, nzira yakanakisisa yekudzivisa kuve nehutachiona hwetsvo ndeyekuti uve nechokwadi chekugamuchira kurapa kwakakodzera kwemoyo wako. Izvi zvinoreva kuti kwete kungoita kurapwa kwaunoda chete kwepfungwa yemwoyo wega pachako (ingave iri CAD, chirwere chemwoyo chinonzi valve, cardiomyopathy, kana chero imwe mamiriro ezvinhu), asiwo kuita zvose zvaunogona kuti uwane uye kuchengetedza hutano hwakanaka hwehutano hwemwoyo wako kazhinji. Izvi zvinoreva kurwisa zvine utsinye chirwere chepfungwa, chirwere cheshuga, uye lipids yakakwirira, kuchengetedza uremu hwakanaka, kusasvuta, nekuwana muviri wakawanda.
Chirwere chepoyo. Sezvatakaona, zvirwere zvepfungwa pachavo zvino zvinoonekwa sechinhu chikuru chekutadza kwekugadzira CAD. Izvi zvinoreva kuti kana uine chirwere chepfungwa, chinova chakakosha zvakakosha kuti uwane kutarisa kwehumwe humwe humwe humwe hutano hwehutano hwemwoyo (izvo zvatichangobva kutaurwa). Utsinye hunokonzerwa nehutachiona hunofanirwa kutungamirirwa hunofanira kuva hukuru hukuru kwauri, uye iwe unofanira kutora chero matanho anodiwa kuti uwedzere ngozi yako.
Mukuwedzera, nyanzvi dzakawanda dzinokurudzira kuti ani naani ane chirwere chisingaperi chepfungwa anofanira kuiswa pamutemo wemishonga , uye kuti kufunga kwakanyanya kunofanira kupiwa prophylactic aspirin . Aya matanho anogona kubatsira kudzivirira mhirizhonga yakawanda yeCAD.
The Bottom Line
Kuva nechirwere chepfungwa kunogona kuwedzera zvikuru njodzi yekuva nechirwere chemwoyo chakakomba, uye pamwe chete. Ani naani ane chirwere chekurapa chinosanganisira chimwe chezvikwata izvi zvemuviri chinofanira kutora chiyero chega chega chinowanikwa kwete kwete chete kugadzirisa kurapa kwezvinoitika kuongororwa, asi kudzivirira kukura kwechinetso chitsva mune zvehutano pane imwe nhengo inokosha.
> Sources:
> Bock JS, Gottlieb SS. Cardiorenal Syndrome: Mutsva Pfungwa. Circulation 2010; 121: 2592.
> Leoncini G, Viazzi F, Pontremoli R. Kuongorora kwehutano hwehutano: Renal Perspective. Lancet 2010; 375: 2053.
> McCullough PA, Jurkovitz CT, Pergola PE, et al. Kuzvimiririra Components yeHIV Kidney Disease seMwoyo Yehutano Dambudziko: Zvibereko Kubva kuRiyo Purogiramu Yokuongorora Yokutanga (KEEP). Arch Intern Med 2007; 167: 1122.
> Ronco C, Haapio M, House AA, et al. Cardiorenal Syndrome. J Am Coll Cardiol 2008; 52: 1527.
> Shishehbor MH, Oliveira LP, Muteuri MS, et al. Kubuda Kwemwoyo Mungozi Njodzi Iyo Ayo Chikamu Chinokosha Chinokonzerwa Nehutano Ngozi In Chronic Chronic Kidney Disease. Am J Cardiol 2008; 101: 1741.