I-Uremia

I-uremia yisimo esihlelekile esenzeka lapho izinso zingasakwazi ukuhlunga ngokuphelele udoti ophuma egazini, okuholela ekunqwabelaneni kobuthi emzimbeni. Njengoba le mikhiqizo kadoti yakha, ingaphazamisa izinqubo eziningi emzimbeni wakho futhi iholele ezimpawu ze-anemia nezinye izinkinga. Lapha, sizoxoxa ngazo zonke izici ze-uremia ngokuningiliziwe. 

Iyini i-Uremia?

Uremia, eyaziwa nangokuthi uremic syndrome noma ukuhluleka kwezinso, kwenzeka lapho izinso zilahlekelwa amandla azo okusebenza ngokugcwele. Injongo eyinhloko yezinso iwukuhlunga igazi (ukukhipha udoti, amanzi engeziwe, nezinto ezinobuthi). Nokho, lapho zihluleka ukwenza kanjalo ngendlela efanele, lezi zinto ziyanqwabelana egazini futhi zidale isimo esaziwa ngokuthi i-uremia.

Ivamise kangakanani i-Uremia?

Ukuvama kwe-Uremia syndrome kuyahlukahluka ngeminyaka, indawo, nezimo ezikhona. Ingozi ye-uremia ikhuphuka ngeminyaka futhi ivame kakhulu kubantu abanomfutho wegazi ophezulu, ongalawuleki sikashukela, noma ezinye izifo ezingamahlalakhona ezikhulisa kancane kancane ingozi yezinkinga zezinso ngokuhamba kwesikhathi. Isifo sezinso i-uremia yisimo esibucayi futhi, uma siyekwa singanakiwe, singasongela ukuphila.

Izimpawu ze-Uremia

Izimpawu ze-uremia zingasukela kokumnene kuye kokuqina, kuye ngezinga lokungasebenzi kahle kwezinso kanye nokugcwala kwemikhiqizo engcolile egazini lakho. Izimpawu ezijwayelekile zihlanganisa:

• Ukukhathala nobuthakathaka obukhulu
• I-nausea nokuhlanza
• Ukulahlekelwa kwesifiso
• Isikhumba esinamahloni
• Ukuvuvukala kwemilenze, amaqakala, noma izinyawo (i-oedema)
• Ukubunzima ukugxila
• Ukuphelelwa umoya
• Ukunambitheka kwensimbi emlonyeni
• Amajaqamba noma amajaqamba
• Ukudideka noma ukudideka

Izinkinga ze-Uremia

• I-Chronic Kidney Disease (CKD): Isimo sesikhathi eside lapho izinso zingakwazi ukusebenza kahle ngenxa yezifo ezifana nesifo sikashukela, umfutho wegazi ophakeme noma i-glomerulonephritis.
• I-Acute Kidney Injury (AKI): I-AKI ukulahlekelwa okungazelelwe kwamandla ezinso zakho okwenza imisebenzi yazo, okubangela uremia. Ivamise ukucushwa ngu kwamanzi emzimbeni noma ukutheleleka futhi ngezinye izikhathi ngenxa yemithi/amakhemikhali.
• I-Obstructive Uropathy: Lesi simo sezinso senzeka lapho ukuvinjelwa noma ukuvaleka komgudu womchamo kuphazamisa ukuchama okuvamile. Ngenxa yalokho, imfucumfucu iyanqwabelana emzimbeni, okuholela ku-uremia.
• I-Glomerulonephritis: Le nqubo yokuvuvukala ithinta amayunithi okuhlunga (i-glomeruli) futhi ngokuvamile iholela ekwehleni kokusebenza kwezinso.
• Isifo sezinso se-Polycystic: Lesi simo esingokwemvelo sokuphila konke singaqhuba ukuthuthukiswa kwama-cyst kwenye noma zombili izinso kanye nokukhubazeka okungenzeka okuqhubekayo kokusebenza kwezinso.

Sifo

Ukuxilongwa kwe-uremia kuhilela inhlanganisela yomlando wezokwelapha, ukuhlolwa ngokomzimba, nokuhlolwa kwaselabhorethri. Udokotela wakho anga-oda ukuhlolwa okulandelayo:

• Ukuhlola Igazi: Ukuhlolwa kwegazi okulula kukala amazinga emikhiqizo engcolile efana i-creatinine kanye ne-urea nitrogen egazini. Amanani aphezulu alezi zinto angasikisela ukuthi izinso azikwazi ukuzisebenza kahle futhi zizikhiphe egazini.
• Ukuhlolwa Komchamo: I-Urinalysis ingase iveze ukuba khona kwamaprotheni, igazi noma okunye okungavamile okuphakamisa isifo sezinso.
• Ukuhlolwa kwesithombe: Lezi zindlela zokuxilonga zibandakanya ukusebenzisa i-ultrasound, i-CT scan, noma i-MRI ukuhlola izinso zakho nokuhlola impilo yazo.
• I-Kidney Biopsy: Phakathi ne-biopsy, odokotela bangasusa isampula encane yezicubu zezinso futhi bayibheke ngaphansi kwe-microscope ukuze banqume imbangela yokusebenza okungavamile.

Ukwelashwa kwe-Uremia

Ukwelashwa kwe-uremia ngokuyinhloko kuncike kumbangela kanye nobukhulu besimo. Okulandelayo ezinye izindlela zokwelapha ezivamile:

• I-Dialysis: Lena inqubo ehlunga udoti, okuhlanganisa ubuthi noketshezi okweqile, ekugelezeni kwegazi lakho lapho izinso zakho zingakwazi ukwenza kanjalo ngempumelelo. Kunezinhlobo ezimbili eziyinhloko ze-dialysis:
• I-Peritoneal Dialysis: Le nqubo ihilela ukusebenzisa ulwelwesi lwesisu sakho (i-peritoneum) ukuhlunga ubuthi nemikhiqizo engcolile egazini lakho.
• I-Hemodialysis: Le ndlela ihilela ukusebenzisa umshini ukuhlunga igazi ngaphandle komzimba wakho.
• Ukufakelwa kwezinso: Ngezinye izikhathi, ngenxa yesifo sezinso sokuphela kwesigaba (ESRD), odokotela bangase batuse ukufakelwa kwezinso esikhundleni sezinso ezihlulekayo ngezinso ezinempilo, ezinikelwe.
• Imithi: Ngokuya ngembangela ewumsuka ye-uremia, udokotela wakho angase akunikeze imithi yokulawula izimo ezihlobene nazo, njengomfutho wegazi ophakeme, isifo sikashukela, noma izifo.
• Ukushintsha Ukudla: Ukunciphisa ukudla kwakho imisoco ethile, njengamaprotheni, i-potassium, ne-phosphorus, kungasiza ekwehliseni ukunqwabelana kwemikhiqizo engcolile egazini lakho.

Izingozi Zezingozi

Kunezici eziningana ezingandisa amathuba okuthuthukisa i-uremia, kuhlanganise:

• Isifo sikashukela: Amazinga eglucose angalawuleki ayimbangela ehamba phambili yesifo sezinso esingamahlalakhona futhi ekugcineni angaholela ku-uremia.
• Umfutho Wegazi Ophakeme: Umfutho wegazi ophezulu ungalimaza imithambo yegazi yezinso ngokuhamba kwesikhathi, okwandisa ingozi ye-uremia.
• Umlando Womndeni: Izimo ezithile ezizuzwe njengefa, njenge-polycystic kidney disease, zingandisa ingozi yokwehluleka kwezinso kanye ne-uremia.
• Ubudala: Isifo sezinso kanye nengozi ye-uremia iyanda njengoba ukhula.
• Ukukhuluphala: Ukukhuluphala ngokweqile noma ukukhuluphala kungafaka izinso zakho ngaphansi kwengcindezi futhi kube nomthelela ekuthuthukisweni kwe-uremia.
• Ukubhema: Ukubhema kuye kwahlotshaniswa nengozi eyengeziwe yesifo sezinso kanye ne-uremia.
• Imithi ethile: Eminye imithi, njengezidakamizwa ezithile ze-chemotherapy kanye nezidakamizwa ezingezona ukuvuvukala (ama-NSAID), zingalimaza izinso uma zisetshenziswe ngokweqile noma ngokungafanele.

Izinkinga ze-Uremia

Uma ishiywe ingalashwa, i-uremia ingaholela ezinkingeni ezinkulu eziningana, okuhlanganisa:

• Ukungalingani Kwe-Fluid kanye Ne-Electrolyte: Ukunqwabelana kwemikhiqizo engcolile egazini kungaphazamisa ibhalansi yoketshezi ne-electrolyte emzimbeni, okuholela ezimeni ezifana ne-edema (ukuvuvukala), amajaqamba emisipha, nokushaya kwenhliziyo okungajwayelekile.
• Izinkinga zenhliziyo: I-uremia ingaba nomthelela ekwakhiweni komfutho wegazi ophakeme, Isifo senhliziyo, kanye nengozi eyengeziwe yokushaywa unhlangothi.
• Ukuphazamiseka Kwethambo Namaminerali: Ukunqwabelana kwemikhiqizo ethile yemfucuza, njenge-phosphorus, kungaholela ekuphazamisekeni kwamathambo njenge-renal osteodystrophy, engabangela ubuhlungu bamathambo, ukuphuka, nokukhubazeka.
• Izinkinga Zemizwa: I-uremia ingathinta ubuchopho nesimiso sezinzwa, okuholela ezimpawu ezifana nokudideka, ukuquleka, kanye ne-coma.
• I-anemia: Ukungasebenzi kahle kwezinso kungaphazamisa ukwakheka kwe-erythropoietin, ihomoni ekhuthaza ukukhiqizwa kwamangqamuzana abomvu egazi, okuphumela ekuphelelweni kwegazi.
• I-Metabolic Acidosis: Ukunqwabelana kwe-asidi emzimbeni ngenxa yokungasebenzi kahle kwezinso kungaphazamisa izinqubo ezihlukahlukene zomzimba futhi kubangele izinkinga ezifana nokuwohloka kwemisipha nokulahlekelwa amathambo.

Prevention

Nakuba ezinye izici ezibangela uremia zingase zibe ngaphezu kokulawula kwakho, kunezinyathelo ezimbalwa ongazithatha ukuze unciphise ingozi yakho:

• Lawula ezinye izifo: Uma unesifo sikashukela, umfutho wegazi ophakeme, noma isifo sezinso, kufanele ulandele iseluleko sikadokotela wakho ukuze ulawule lezi zimo ezelaphekayo.
• Landela indlela yokuphila enempilo: Ukudla ukudla okunempilo, ukujima nsuku zonke, nokuyeka ukubhema kungakunikeza ukuvikeleka kwezinga lokuqala ezinsweni zakho.
• Phuza amanzi: Ukuhlala unamanzi amaningi kusiza izinso zakho zisebenze kangcono futhi kunciphisa amathuba okuqongelela udoti.
• Ukuphathwa kwemithi: Eminye imithi, amakhemikhali kanye nezinto kungaba yingozi ezinso zakho, ngakho-ke kungcono ukulandela iseluleko sikadokotela wakho.
• Izinguquko ekudleni: Ukuphatha inani lamaprotheni, i-potassium ne-phosphorus oyisebenzisayo kungakhawulela ukuvikelwa komkhiqizo okusaphaza okunqwabelana egazini lakho.

Uzoyibona Nini Udokotela

Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, kubalulekile ukufuna usizo lwezokwelapha ngokushesha:

• Ukuncipha kokuphuma komchamo noma ubunzima bokuchama
• Imilenze evuvukele, amaqakala, noma izinyawo
• Ubuthakathaka obukhulu
• Ukudideka noma ukudideka
• Ukuphelelwa umoya
• Amajaqamba amakhulu emisipha noma ama-twitches

Isiphetho

I-uremia yisimo sesistimu lapho izinso zihluleka ukwenza imisebenzi yazo, njengokukhipha ubuthi, udoti, noketshezi oluningi. Uma iyekwa ingalawuleki, i-uremia ingaphenduka inkinga enkulu enomthelela kuwo wonke umzimba. Uma uzazi izimbangela, izimpawu kanye nokwelashwa, ungathatha izinyathelo zokunakekela impilo yezinso zakho futhi ufune usizo ngokushesha lapho kudingeka. Khumbula ukuthi ukuxilongwa ngesikhathi kanye nokwelashwa okulungile kungase kuvimbele noma kubambezele i-uremia, kanye nezinkinga zayo.

Imibuzo Evame Ukubuzwa

1. Ubani okungenzeka kakhulu ukuthi athole uremia?

Abantu abanesifo sikashukela, isifo sezinso esingamahlalakhona, noma i-BP ephezulu basengozini enkulu yokuba ne-uremia. Abantu abadala asebekhulile kanye nalabo abanomlando wokuphazamiseka kwezinso emndenini nabo bangathinteka kakhulu.

2. Yiluphi uhla olujwayelekile lwe-uremia?

Alikho izinga eliqondile le-uremia. Kuyisimo esibonakala ngokunqwabelana kwemfucuza egazini. Odokotela baqapha amazinga ezinto ezifana ne-creatinine ne-blood urea nitrogen (BUN) ukuze bahlole ukusebenza kwezinso futhi bathole i-uremia.

3. Isiphi isigaba sesifo sezinso i-uremia?

I-uremia ngokuvamile ivela ezigabeni zakamuva zesifo sezinso esingamahlalakhona, esivame ukubizwa ngokuthi isigaba sesi-4 noma isigaba sesi-5 (isifo sezinso sokuphela kwesigaba noma i-ESRD). Kulezi zigaba, izinso zisebenza ngaphansi kwamaphesenti angama-30 womthamo wazo ojwayelekile, okuholela ekwakhekeni kukadoti egazini.

4. Ingabe ukufakelwa izinso inketho yokwelapha uremia?

Yebo, ukufakelwa izinso kuyindlela yokwelapha yabantu abanesifo sezinso sokuphela kwesigaba (ESRD) kanye ne-uremia. Ukufakelwa kwezinso okuphumelelayo (i-KTP) kungabuyisela ukusebenza kwezinso okuvamile futhi kungafaki isidingo se-dialysis.

5. Ingabe ukusebenza kwezinso kungaba ngcono ngaphandle kwe-dialysis?

Kwezinye izimo, ukusebenza kwezinso kungase kuthuthuke ngaphandle dialysis. Lokhu kuncike kumbangela yokukhubazeka kwezinso. Isibonelo, uma i-uremia ingenxa yokulimala kabi kwezinso ngenxa yokuphelelwa amanzi emzimbeni noma imithi ethile, ukulungisa inkinga kungasiza izinso ukuba zilulame. Kodwa-ke, esifweni sezinso esingamahlalakhona noma isifo sezinso sokuphela kwesigaba (ESRD), i-dialysis noma ukufakelwa kwezinso (KTP) ngokuvamile kuyadingeka ukuze kulawuleke i-uremia ngokuphumelelayo.

UDkt. B. Aravind Reddy

MBBS, MD, DM (Nephrology)
CARE Hospitals, HITEC City, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

1