Izifo Zesifo Sengculazi

Isifo sezinso esingamahlalakhona (CKD), esaziwa nangokuthi ukwehluleka kwezinso okungamahlalakhona, sivamise ukukhula kancane ngokuhamba kwesikhathi ngenxa yezimo ezifana nalezi. sikashukela noma umfutho wegazi ophezulu olimaza izinso. Lo monakalo ukhinyabeza amandla ezinso okuhlunga udoti kanye noketshezi oluningi. Njengoba lesi sifo siqhubeka, ukusebenza kwezinso kuqhubeka nokuncipha, ngokuvamile ngaphandle kwezimpawu eziphawulekayo ezigabeni zokuqala. Ngokuhamba kwesikhathi, i-CKD ingaholela ezinkingeni ezinkulu zempilo uma ingalawulwa ngendlela efanele.

Izigaba Zezifo Ezingamahlalakhona Zezinso

Izigaba zezinso ezingalapheki zihlukaniswa ngezigaba ezi-5 ezihlukene ngokwezinga lomonakalo nokuncipha kokusebenza kwezinso, okungokulandelayo:

• Isigaba 1: Ukulimala kwezinso nge-GFR evamile noma ephezulu, engu-90 noma ngaphezulu.
• Isigaba 2: Ukulimala kwezinso ngokuncipha okuncane ku-GFR, 60-89.
• Isiteji sesi-3: Ukwehliswa okumaphakathi ku-GFR, 30-59.  
• Isiteji sesi-4: Ukwehliswa okukhulu kwe-GFR, i-15-29.
• Isiteji sesi-5: Ukuhluleka kwezinso zesigaba sokugcina: GFR <15-ukuhluleka kwezinso.

Izimpawu Zesifo Sezinso Ezingamahlalakhona

Izimpawu ze-CKD zingaba ezicashile ezigabeni zokuqala futhi zibonakale kakhulu njengoba isifo siqhubeka. Izimpawu ezijwayelekile zihlanganisa:

• Ukukhathala, ukuphelelwa amandla, nokuba buthakathaka
• Ukuvuvukala emilenzeni, amaqakala, izinyawo, nezandla
• Ubunzima bokuphefumula
• I-nausea nokuhlanza
• Ukulahlekelwa kwesifiso
• Ukunwaya okuqhubekayo
• Amehlo akhukhumele.
• Ukushintsha imvamisa yokuchama-umchamo owenyukayo noma owehlile futhi onombala omnyama
• Umchamo unegwebu noma unegwebu
• Ama-cramp muscle
• Ukuqwasha nokungakwazi ukugxilisa ingqondo.
• Umfutho wegazi ophezulu
• Umbala wesikhumba sakho uyashintsha.

Izimbangela Zezifo Zezinso Ezingamahlalakhona

Umfutho wegazi ophakeme (i-hypertension) nesifo sikashukela yizona zimbangela ezimbili ezivame kakhulu zesifo sezinso esingamahlalakhona. Ezinye izimbangela nezimo ezithinta ukusebenza kwezinso futhi ezingabangela isifo sezinso esingamahlalakhona zihlanganisa:

• IGlomerulonephritis: Ukuvuvukala kwamayunithi okuhlunga izinso.
• I-Polycystic Kidney Disease: Isifo se-Polycystic Kidney: Ukuphazamiseka kofuzo okwenza ama-cyst akheke ezinso.
• Ukusetshenziswa isikhathi eside kwama-NSAID: Ukusetshenziswa isikhathi eside kwezidakamizwa ezilwa nokuvuvukala kungalimaza izinso.
• Ukutheleleka Kwezinso Okuphindaphindiwe: Ukutheleleka njalo kungabangela ukulimala kwezinso.
• I-nephropathy ehlobene nesifo sikashukela: Lokhu kwenzeka lapho isifo sikashukela siholela ekulimaleni noma ekuhlulekeni kwemizwa eyodwa noma ngaphezulu.
• I-Vesicoureteral Reflux: Kulesi simo, umchamo uphuma ezinso zakho ubuyisela ureters wakho.
• I-Membranous nephropathy: Lesi yisimo lapho ulwelwesi lwezinso oluhluza udoti luhlaselwa amasosha omzimba wakho.

Ukuxilonga isifo sezinso esingamahlalakhona

Ngaphambi kokuqala noma yikuphi ukwelashwa, udokotela wakho uzobuyekeza umlando wakho wezokwelapha, akuhlole ngokomzimba, abuze nganoma yimiphi imithi yamanje oyiphuzayo, futhi akubuze nganoma yiziphi izimpawu oye waba nazo. Ezinye izivivinyo zokuxilonga zibandakanya:

• Izivivinyo zegazi: Amazinga emikhiqizo engcolile, njenge-creatinine ne-urea, ayaqashwa.
• Ukuhlolwa Komchamo: Ukubona ukungahambi kahle komchamo okuholela ekukhishweni kwamaprotheni noma igazi.
• Ukuhlolwa Kwezithombe: I-Ultrasonography noma i-CT scan ingenziwa ukuze ubone ngeso lengqondo izinso kanye nokwakheka kwazo.
• I-Kidney Biopsy: Kwezinye izimo, isampula encane yezicubu zezinso ihlolwa ngaphansi kwe-microscope.

Ukwelashwa Kwezifo Ezingamahlalakhona Zezinso

Alikho ikhambi lesifo sezinso esingamahlalakhona; nokho, ingaphathwa. Umgomo oyinhloko wokwelapha isifo sezinso esingamahlalakhona uwukubambezela ukuqhubeka kwesifo nokulawula izimpawu. Ukwelashwa kwezifo ezingapheli zezinso kuhlanganisa:

• Imithi: Ukwelashwa kunganikezwa ukulawula ukushaya kwegazi, izinga likashukela egazini.
• Izinguquko Zokudla: Ukunciphisa amazinga kasawoti, amaprotheni, ne-potassium kunciphisa ukucindezela ezinso.
• I-Dialysis: Esifweni esithuthukisiwe, i-dialysis ingase idingeke ukuze kukhishwe imikhiqizo engcolile kusukela ekujikelezeni.
• Ukufakelwa Kwezinso: Ukufakelwa kwezinso kungadingeka uma isifo sezinso esingamahlalakhona sifinyelela esigabeni esithuthukile.

Izingozi Zezingozi

Izici ezithile zandisa ingozi yokuthuthukisa i-CKD:

• Isifo sikashukela kanye nomfutho wegazi ophakeme 
• Umlando womndeni 
• Iminyaka yobudala, ivame kakhulu kubantu abangaphezu kweminyaka engama-60
• Ukukhuluphala 
• Ukubhema 
• Ukwakheka kwezinso okungajwayelekile

Izinkinga

Umzimba wakho wonke ungase uhlaselwe yisifo sezinso esingamahlalakhona. Imiphumela emibi engaba khona yesifo sezinso esingamahlalakhona:

• Isifo senhliziyo 
• Ubuthakathaka bethambo 
• I-anemia 
• Ukugcinwa kwe-Fluid 
• Ukungalingani kwe-Electrolyte 
• Ukwenyuka okungazelelwe kwamazinga e-potassium egazini
• Ukunciphisa ukuphendula komzimba
• Izinkinga ngesikhathi ukukhulelwa 
• I-Pericarditis, ukuvuvukala kwe-membrane efana nesaka ezungeze inhliziyo.

Uzoyibona Nini Udokotela

Uma umuntu ehlushwa ukukhathala okungapheli, ukuvuvukala, ukushintsha kwendlela yokuchama, noma umfutho wegazi ophakeme, kufanele afune usizo lwezokwelapha ngokushesha. Ukutholwa kusenesikhathi kungenza umehluko omkhulu ekulawuleni lesi sifo.

Prevention

Ukunciphisa amathuba okuba nesifo sezinso:

• Gcina umfutho wegazi lakho kanye namazinga kashukela egazini ulawula
• Gcina isisindo esinempilo
• Gwema ukubhema 
• Hlala u-hydrated 

Isiphetho

Isifo sezinso esingamahlalakhona siba sibi kakhulu ngokuhamba kwesikhathi futhi singathinta izinga lakho lempilo. Ukuze usilawule kangcono, kubalulekile ukugxila ekuvimbeleni isifo nokusibona kusenesikhathi. Lokhu kusiza ukunciphisa imiphumela yakho futhi kuthuthukise imiphumela kulabo abathintekile. Ukuhlala unempilo kanye nokuhlolwa njalo kubalulekile ekugcineni izinso zakho ziphilile.

Imibuzo Evame Ukubuzwa

Q1. Sivame kangakanani Isifo Sezinso Ezingamahlalakhona?

Izimpendulo. Kulinganiselwa ukuthi isifo sezinso esingamahlalakhona sithinta cishe u-10% wabantu bomhlaba. Iyaqhubeka nokukhula kubantu asebekhulile, namazinga akhuphukayo esifo sikashukela kanye nomfutho wegazi ophakeme—okuyinto ekhathaza kakhulu impilo yomphakathi emhlabeni wonke.

Q2. Yikuphi ukudla okungalungile ezinso?

Izimpendulo. Ukudla okune-sodium eningi, inyama egayiwe, iziphuzo ezinoshukela, ukudla okune-phosphorus ephezulu—njengemikhiqizo ethile yobisi namantongomane, nokudla okune-potassium ephezulu—ngokwesibonelo, ubhanana namawolintshi, kungaba yingozi ezinso, ikakhulukazi uma kukhona isifo sezinso esingamahlalakhona.

Q3. Ungakwazi yini ukululama ngokugcwele ku-CKD?

Izimpendulo. Cha, i-CKD ayikwazi ukwelapheka ngokuphelele. Kodwa-ke, ukuqhubekela phambili kungalawuleka futhi kwehliswe ngokwelashwa okufanele kanye nezinguquko endleleni yokuphila nemithi engathuthukisa izinga lempilo nokusebenza kwezinso.

Q4. Ngihlola kanjani ukuthi izinso zami zilungile yini?

Izimpendulo. Udinga ukubonisana nodokotela. Udokotela uzokunikeza ukuhlolwa kwegazi, umchamo, kanye nokuhlolwa okungenzeka kwezithombe ukuze abone ukuthi izinso zakho zisebenza ngendlela enempilo. Ukuhlola kuzokhombisa ukuthi izinso zisebenza kahle kangakanani futhi uma kukhona ukungahambi kahle noma ubufakazi besifo sezinso esingamahlalakhona.

Q5. Unjani umbala womchamo uma izinso zakho zingasebenzi?

Izimpendulo. Enye yezimpawu lapho wakho izinso azisebenzi ukuthi umchamo wakho uba mnyama, ucishe ube nsundu, ubebomvu, noma ube nombala wetiye. Izikhathi eziningi, lokhu futhi kuyinkomba yokuthi igazi noma imfucuza eyengeziwe ikhona emchameni. Ukwengeza, kungase kube namagwebu noma kuguquguquke uma unamaprotheni amaningi noma ezinye izinto okungafanele ngempela zibe semchameni wakho.

UDkt. Pradip Saruk

MBBS, MD, DM Nephrology
Izibhedlela Ezihlangene ze-CIIGMA (Iyunithi Yezibhedlela ze-CARE), Chh. Sambhajinagar

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

11