Chii chiNefirologist uye Ndirini Unofanira Kuona Rimwe?
Nefirologists ndivo vanachiremba vanonyanya kuzivikanwa uye kurapwa kwezvirwere zvepuro. Ndezvipi zviitiko zvinobatwa nehapi chiremba, uye rinotumirwa kune mumwe wezviongorori dzinodiwa?
Dhiyo Dzaase Overview
Kana usina kumbonzwa nezve nephrology (kuongorora kwepfungwa yepso) zvisati zvaitika, hazvishamisi. Chirwere chepfungwa chisingaperi (CKD) inowanzotumidzwa se "muurayi anyerere," sezvo vanhu vazhinji vane zviratidzo zvishoma kana kuti hapana zviratidzo zvachose kana vaongororwa.
Kune mazita mazhinji akasiyana-siyana anogona kushandiswa kurondedzera chirwere chepfungwa chinogona kuwedzera kumhirizhonga. Sezvakataurwa pamusoro apa, Nehrologists ndivo vanachiremba vanorapa zvirwere zvepfungwa, nezwi rechiGiriki rokuti "nephros" rinoreva zvinso. Iwe unogonawo kunzwa izwi rokuti renal chirwere chinoshandiswa kurondedzera zvinetso zvepvo. Izwi rokuti renal rinobva mumutauro wechiLatini "renes" iro rinorevawo itsvo.
Ndeapi maitiro ehutano angakanganisa tsutsvo dzako, ndezvipi zvimwe zviratidzo zvinowanzoonekwa, uye kana iwe uchifanira kutumirwa kune nephrologist? Zvidzidzo zvinoratidza kuti kunonoka kushanyirwa kune nyanzvi yezinyanzvi kunogona kuwedzera njodzi yako yezvinetso kana kufa, saka uyu mubvunzo unokosha.
Mamiriro Ekutongwa neDhinney Doctors (Nephrologists)
Chiremba vanachiremba vanotarisira vanhu vane marudzi akasiyana-siyana ezvirwere zvepfungwa kusanganisira:
- Kuora kwepfungwa zvakanyanya: Chirwere chepfungwa chakanyanya chinoreva kukurumidza kukurumidza kwezvirwere zvepvo zvinowanzoenderana nemamiriro ezvinhu akadai sekutyisa (kuderedzwa ropa kukanganiswa kwetsvo), kuora mvura, kana zvinetso zvepfungwa zvine chokuita nekuvhiyiwa
- Kukanganiswa kwemazuva ekupedzisira: Chirwere chisingaperi chirwere chinogona kukonzerwa nemamiriro ezvinhu akasiyana-siyana (ona pasi apa)
- Ipiyo matombo: Kune marudzi akasiyana einso marombo angave kana asingagoni kubvisa zviratidzo
- Ipi zvirwere (pyelonephritis): Izwi rokuti "urinary tract infection" rinoreva mamiriro ezvinhu akawanda kubva kumabhakitiriya mumuguta, kusvika kune zvirwere zvinoshungurudza zvirwere, kuhutachiona hwetsvo ( pyelonephritis )
Pane zvinetso zvakasiyana-siyana zvehutano izvo zvingakanganisa maitsvo nenzira dzakasiyana. Mimwe yemamiriro ezvinhu akajairika anogona kukonzera kusvuta kwepfungwa inosanganisira:
- Chirwere cheshuga ( chirwere cheshuga nephropathy ): Chirwere cheshuga ndicho chinokonzera kukanganisa kwepso muUnited States
- Chirwere chepfungwa chinokonzerwa nehuwandu hwemhepo uye chirwere chemwoyo ( cardiorenal syndrome )
- Kuwedzera muviri
- Kuora kwepfungwa dzisingaperi
- Ipiyo mabwe anokonzera kuvhiringidzika
- Congenital (kubva pakuberekwa) zvinetso zvepfungwa zvakadai semabhiza ehwehh
- Glomerulonephritis: Glomerulonephritis inoputira maitsvo anokwanisa kukonzerwa nenhamba dzakasiyana-siyana, kusanganisira mabhakitiriya anokonzera strep throat.
- Chirwere chepyo chichienderana ne lupus ( lupus nephritis )
- Chirwere chePycycystic yechinyo: Chirwere chepfungwa chinonzi cystic chinotora, kunyange chiremera chechirwere, pamwe nezera rekutanga, chinogona kusiyana
- Kuita zvirwere zvakadai seIgA nephropathy
- Kuora kwepyiviri kuchipatara chechiropa ( hepatorenal syndrome )
Chirwere chepfungwa chisingaperi chinorondedzerwa nezvikamu zvishanu zvichienderana nekuoma kwechirwere. Bhuku 1 kusagadzikana kwepvo rinoreva zvirwere zvishoma, asi gorosi kusakundikana kwemasimba kunowanzoratidza kuti dialysis kana kuchinja kwepvo kuchadiwa.
Mukuwedzera pakugadzirisa zvinetso zveputsvo (kuedza kururamisa mamiriro acho kana kuti kuzvidzivirira kuti zvirege kuipa), madhere rezinso anoronga zviratidzo zvinowanzobatanidzwa nezvirwere zvepfungwa, zvakadai sekuvhiringidzika kwe electrolyte (kunyanya zvinetso ne potassium mazinga) uye kuwedzerwa kweropa.
Zviratidzo zveDease Disease
Kuti uchinzwisise zviratidzo zvinowanzozivikanwa zvezvirwere zvepuro, zvinobatsira kuongorora sarudzo nekushanda kwetsvo . Nzvo dzenyu dziri panzvimbo dzenyu, pedyo nepamusoro. Kukuvadza kumusana wako kana rutivi pasi pejeri yako inogona kukonzera kukuvadzwa kwetsvo dzako. Tsitsi dzako dzinoita mabasa anokosha anoverengeka. Izvi zvinosanganisira kuchenesa ropa rako kubvisa tsvina, kuchengetedza mazinga akakodzera e electrolytes (akadai sodium uye potassium) kuti uone kushanda zvakanaka kwemasero ako, nekuchengetedza mvura yakakwana mumuviri wako.
Kana iwe uchinge waora mvura, itsvo dzako pakutanga dzinoita kuti udzorere chimiro chemvura mumuviri wako, asi kukuvara kwepvo kunogona kuitika nekugara kwenguva yakareba kana kwakanyanya kuora mvura. Kana itsvo dzako dzisingashandisi zvakanaka, uwandu hwe sodium uye potassium mumuviri wako unogona kuve wakagadzikana. Matambudziko eElectrolyte ane chirwere chepfungwa anogona kuva yakakomba, Sezvo kukwana kwakakwana kwe potassium kunodiwa kuitira kushanda zvakanaka kwemoyo wako, zvinetso zvepfungwa zvinogona kuita kuti mwoyo usati wadzika.
Kushaya ropa kwemazuva ose, ingave yakakwirira kana pasi kunogona kukonzera kuora kwepvo. Kuora kweiyo, pamwe chete, kunogona kukonzera matambudziko mukugadzirisa ropa rako.
Itsvo dzinobatanidzwawo pakuita hormone inobatanidza mukugadzirwa kwemasero matsvuku eropa. Nokuda kwechikonzero ichi, chirwere chepfungwa chinogona kukonzera anemia , iyo yakaderera ropa rekuyera masero.
Vamwe vanhu vane zvinetso zvekuvhenekera, zvakadai sekuoma kunyorera. Pane dzimwe nguva vanhu vanewo marwadzo eruva, nekuda kwenzvimbo yeivo. Ipi mairo anogona kuzvirumbidza nemarwadzo akaremara akafananidzwa nekuberekwa asi anogona kuvapo pasina kurwadziwa zvakare.
Zviratidzo zvisingaoneki kana zvisinganzwisisiki zvakajairika, uye chikonzero nei uchifanira kuona chiremba wako kunyange iwe usingagoni kunyatsoziva zviratidzo zvako. Izvi zvinogona kusanganisira kuneta, kusuruvara, kana kutora mutsvuku mumuromo mako.
Pakutanga uye nehutano hwetsvo, uye dzimwe nguva kunyange nehutachiona hwepfungwa, vanhu vangave vane zviratidzo zvishomanana. Zvechokwadi, chiratidzo chakakurumbira chezvirwere zvepvo hazvina zviratidzo zvachose !
Kuongorora zvirwere zvepoyo
Kune mhando dzakasiyana dzakasiyana siyana dzeongororo dzinogona kuitwa kuvhara uye kutevera zvinetso zvepvo. Izvi zvinosanganisira kuongorora ropa (zvakadai seBUN (ropa urea nitrogen), Cr (creatinine), uye GFR (glomerular filtration rate)), urinhokuedza (kunyanya kutarisa proteinuria ), uye kufungidzira maitiro akadai seTCT, MRI, uye IVP.
Nguva Yakanakisisa Yokuona muNefirologist
Nguva iyo yakanakisisa kuona nyanzvi yezinonzi nephrologist zvinogona kusiyana zvichienderana nemamiriro ako ezvinhu. Izvozvo zvakati, iwe unofanirwa kuonekwa neveroprologist kana creatinine yako yakakwirira zvakakwana kunzi CKD Stage 4. Izvozvo zvinoreva kuti GFR inopfuura 30.
Kukosha Kwokutaurirwa Nefirologist
Handiri kusimbisa kukosha kwekutumira kune imwe nyanzvi yezinyanzvi nokuti ini ndiri mumwe. Ichokwadi, zvidzidzo zvakawanda zvezvechiremba zvakaratidza zvakajeka kuti varwere vanotumidzwa kumashure kune nephrologists vanogona kufa, kana kuti kufambira mberi ku dialysis!
Zvinokonzera Njodzi Dzeve Disease
Sezvo chirwere chetsvo chinogona kuva chakakomba zvisati zvaitika zviratidzo, zvakakosha kuti uve nehuwandu hwekunyunyuta uye uzive nezvemamiriro ezvinhu anokonzera kuti uwane zvirwere zvepfungwa. Vanhu vari mungozi yakanyanya yekukurira kukanganisa kwenhema kunosanganisira avo vane:
- Chirwere cheshuga
- Yenguva-yakamira yepamusoro yeropa
- Zvirwere zvemwoyo zvakadai sechirwere chirwere chetano, kana congestive moyo kusagadzikana
- Zvimwe zvirwere zvevascular zvakadai sa cerebrovascular disease (strokes) uye mhirizhonga vascular disease (zvakadai seanortic aneurysms)
- Imwe mhuri ine chirwere chetsvo
- Kushandiswa kwemishonga kwenguva refu isiri-steroidal anti-inflammatory drugs (NSAIDS) dzakadai seAppil (ibuprofen) uye Celebrex
Mishonga
Mishonga yezvirwere zvepuro inowirirana zvikuru zvichienderana nechikonzero chaicho. Kana mafungiro epiyo akaderedzwa zvakanyanya munhu angada chirwere che dialysis nokuda kwetsvo kusagadzikana kana kupora kwepvo.
Kuva Murevereri Wako Nezvipi Zvako
Kana iri kuuya kune chirwere chepfungwa, kupora kazhinji hazviitiki kana GFR yako ichiramba ichiramba kusvika kumatanho akapfuura. Nokudaro, kusimbiswa kunonyatsoda kuva mukudzivirira. Nguva inotevera paunoona chiremba wako aine chokwadi chekukurukurirana migumisiro yeGFR yako uye kukumbira kana iwe uchifanira kuonekwa nemumwe nyanzvi.
Pasi pepamusoro paNzira Yokuona Chiremba Chiremba
Nguva yakanakisisa yekuona chiremba chiremba ichasiyana maererano nekushanda kwako kwepso, iyo chaiyo yemhuka inenge uine, uye zvimwe zvipingamupinyi. Zvinoratidzika kuti kutumirwa kunoona nyanzvi yezinonzi nephrologist inofanira kufungidzirwa kune yakakwirira Cr (gadziriro 4) kana GFR pasi pe30, asi vamwe vanhu vanofanira kuona chirwere chepfungwa nokukurumidza. Sezvo kubvunzurudzwa panguva yakakodzera neine nrorologist kunobatanidzwa nekupona, zvakanakisa kutadza kune rumwe rutivi rwekuona mumwe wevakirini ava kare pane zvishoma.
> Sources:
> Kim, D., Kim, M, Kim, H. et al. Kutarisa Kutanga Kumunhu weNefrologist Kuvandudza Mwoyo Murefu Kurarama: Prospective Cohort Chidzidzo cheMagumo Ekupedzisira Matenda Echirwere muKorea. PLoS One . 2013. 8 (1): e55323.
> Smart, N., Dieberg, G., Ladhani, M., naT. Titus. Kutarirwa Kwokutanga Kumudzidzisi Nephrology Dhipatimendi Rokudzivirira Kufambira Mberi Kuguma-Stage Disease Disease. Cochrane Database yekutarisa kwakarongeka . 2014. (6): CD007333.
> Smart, N., naT. Titus. Migumisiro Yekutanga Kubva Pamberi Pemazuva Nefirology Kuendeswa Muhutano Hwepfungwa Hwepachivi: Kurongeka Kwakarongeka. American Journal of Medicine . 2011. 124 (11): 1073-80.e2.