Amaprotheni ku-Urine

Amaprotheni adlala indima ebalulekile ekwakhiweni komzimba. Umzimba wakho udinga amaprotheni ukuze ulwe nezifo, ulawule ibhalansi yoketshezi, futhi ukuthuthukisa imisipha namathambo. Kodwa-ke, ngezikhathi ezithile, ukuba khona kwamaprotheni aphezulu emchameni kungabonisa inkinga yezinso noma esinye isifo. Uma izinso zethu zingasebenzi kahle, amaprotheni angase adlule ezihlungi nasemchamo wethu. Igama lalesi simo lithi Proteinuria noma albuminuria. Ukuba khona kwamaprotheni emchameni kubonisa ukuthi izinso zethu zisesimweni esibi.

Asho ukuthini amaprotheni emchameni?

I-Proteinuria, eyaziwa nangokuthi ukuvuza kwamaprotheni emchameni, yisimo esibonakala ngenani eliningi lamaprotheni atholakala egazini emchameni. Amaprotheni angenye yezingxenye ezihlolwe ekuhlolweni kwelebhu ukuze kuhlaziywe umchamo. Lesi simo sezempilo ngokuvamile sibonisa isifo sezinso. Izinso zethu zisebenza njengezihlungi ngokuvamile ezivimbela amaprotheni amaningi ukuba angadluli. Kodwa-ke, amaprotheni afana ne-albumin angaphuma igazi emchameni lapho izinso zihlaselwa yizifo. Lawa maprotheni agcina esemchamweni agcina ekhishwe emzimbeni, okungaba nemiphumela elimazayo empilweni yonke. I-proteinuria ingenzeka futhi lapho umzimba ukhiqiza inani eliningi lamaprotheni.

Ingabe amaprotheni emchameni ayingozi?

Ukuba khona kwamaprotheni emchameni kubonisa inkinga enkulu kakhulu. I-proteinuria ihlotshaniswa nengozi ephezulu yokufa izifo zenhliziyo nezenhliziyo. Kwezinye izimo, i-proteinuria isebenza njengesibonakaliso esiyisixwayiso sesifo sezinso esingamahlalakhona (CKD). Kodwa-ke, kungenzeka futhi ukuthi ube ne-CKD futhi ube namaprotheni ajwayelekile emchameni. Njengoba ukusebenza kwezinso kuncipha kancane kancane ngenxa ye-CKD, i-dialysis, ukufakelwa kwezinso, noma kokubili kungase kudingeke esikhathini esizayo. Izinso nazo zingaba nenkinga yesifo sikashukela kanye nomfutho wegazi ophezulu (hypertension).

Yini ebangela amaprotheni emchameni?

Izinso ezinempilo ziguqula imfucuza kanye noketshezi oluningi olusuka egazini lube umchamo. Amaprotheni nezinye izakhi ezibalulekile azikhishwa izinso ezinempilo; kunalokho, bayadlula futhi babuyele emgudwini wegazi. Nokho, izinso ezilimele zingase zivumele le phrotheni ukuthi igeleze emchamweni.  

Lokhu okulandelayo yizimbangela ezivamile ze-proteinuria: 

• Isifo sezinso
• Diabetes
• Izimo ezithile ze-immunological
• Umfutho wegazi ophezulu
• isifo senhliziyo
• Ukuhluleka kwenhliziyo ukulahla
• ukukhulelwa
• Umlando womndeni wesifo sezinso
• Umdlavuza we-Plasma cell 
• ukuhlukumezeka

Inani eliphakeme lesikhathi esifushane lamaprotheni emchameni lingaba uphawu lwezinkinga zempilo eziningana, njenge:

• Ukuphelelwa amanzi emzimbeni 
• Ukucindezeleka okukhulu
• Fever
• Ukubanda kakhulu
• Izinso Stone
• Ukuzivocavoca umzimba ngezinga eliphezulu
• Ukutheleleka kwe-Urinary tract

Kungani ngidinga amaprotheni ekuhlolweni komchamo?

Ukuba khona kwenani elikhulayo lamaprotheni emchameni ngokuhamba kwesikhathi kungase kube inkomba yokuqala yokuthi isifo sezinso noma esinye isimo sidale umonakalo ezinso. Ukuhlolwa kwamaprotheni omchamo kungasiza ekutholeni isifo sezinso kusenesikhathi ukuze kuthathwe izinyathelo zokuvikela izinso zakho. Njengengxenye yokuhlola okuvamile noma uma isiguli sibonisa izinkomba zokulimala kwezinso, udokotela angase anikeze iphrotheni ekuhlolweni komchamo.

Yiziphi izimpawu zamaprotheni emchameni?

Ngeke kube nezimpawu zeprotheyini emchamweni uma izinso zilimele kancane futhi uma umchamo unamaphrotheni amancane kuphela. Lapho izinso zilimele kakhulu futhi kunamaprotheni amaningi emcinini, izimpawu ezilandelayo ze-proteinuria zingase zivele:

• Umchamo onegwebu noma amabhamuza
• Ukungabi nesifiso
• Ukuphefumula ubunzima
• Ukuvuvukala ebusweni, esiswini, ezinyaweni noma ezandleni
• Ukuzwa ukuququda noma ukuhlanza
• Ukuncipha kwemisipha ebusuku
• Ukwanda kwemvamisa yokuchama

Yiliphi izinga le-proteinuria eliphathelene?

Ngaphansi kuka-150 mg weprotheyini ngosuku iphrotheni yomchamo uhla olujwayelekile lwe-mg dL. Izinga le-proteinuria lichazwa ngokuba namaprotheni angaphezu kuka-150 mg ngosuku emchameni. Kuye ngezimo zaselabhorethri, umkhawulo ophezulu wezinga lephrotheni elivamile emchameni ungase uhluke kancane. I-proteinuria ebangeni le-nephrotic ichazwa ngokuthi ine-3 kuya ku-3.5 amagremu wamaprotheni emchameni. I-Nephrotic syndrome, ukugula okungajwayelekile, kubangela inani eliningi lamaprotheni ukuthi likhishwe ezinso lingene emchameni.

Amaprotheni asezicini eziyingozi zomchamo

Izinto ezilandelayo zingase zandise ingozi yakho yokudlula amaprotheni emchameni wakho:

• Ukukhuluphala
• Umfutho wegazi ophezulu
• Ukuba mdala kune-65
• Diabetes
• Umlando womndeni wesifo sezinso

Abanye abantu badlula amaprotheni amaningi emchamweni wabo lapho bemile uma beqhathaniswa nalapho belele. Lesi simo ngokwezokwelapha saziwa ngokuthi i-orthostatic proteinuria.

Itholakala kanjani iphrotheni emchameni?

Ukusiza ekuxilongweni kwe-proteinuria, udokotela uzokwenza ukuhlolwa kwe-dipstick. Phakathi nalokhu kuhlolwa, umuntu kuzodingeka ukuthi achamele esitsheni esikhethekile esinikezwe udokotela. Okulandelayo, udokotela uzofaka idiphu yepulasitiki encane enamakhemikhali akhethekile esitsheni. Umbala we-dipstick uyashintsha uma ulandelela amaprotheni emchameni. Umchamo osele uzophinde uhlolwe nguchwepheshe wezokwelapha esebenzisa i-urinalysis. Ukuhlaziywa komchamo kuhlola izingxenye ezibonwayo, zamakhemikhali, nezincane kakhulu zomchamo ngaphansi kwesibonakhulu. Udokotela ubheka izinto okungafanele zibe khona emchamweni, njengamangqamuzana egazi abomvu, amangqamuzana amhlophe egazi, amagciwane, noma amakristalu amaprotheni anamandla okwenza amatshe ezinso.

Ukwelashwa kwamaprotheni emchameni

Isizathu samaprotheni emchameni sinquma ukwelashwa okufanele kwe-proteinuria. Kudingeka amakhambi ahlukene ngesizathu ngasinye.

• Uma isiguli sinesifo sikashukela, udokotela uzosebenzisana naso ukuze enze isu lokwelapha ukulahlekelwa ngamaprotheni ekwelapheni umchamo futhi avimbele ukulimala kwezinso. Ukwengeza, ukuhlolwa kwegazi kwaminyaka yonke kwesilinganiso sokuhlunga kwe-Glomerular (kukala ukuthi lingakanani igazi elisefa izinso zakho ngomzuzu ngamunye) okufanele zenziwe.
• Uma isiguli sinomfutho wegazi ophakeme, udokotela angase asinikeze imithi yokulawula umfutho wegazi futhi ibambezele ukulimala kwezinso.
• Ngisho noma isiguli singenaso isifo sikashukela noma umfutho wegazi ophakeme (umfutho wegazi ophezulu), udokotela angase atuse umuthi we-antihypertensive ukubambezela ukulimala kwezinso.
• Iziguli ezikhulelwe ezinomlando we-preeclampsia (umfutho wegazi ophakeme ngesikhathi sokukhulelwa) kufanele zihlele izikhathi zokubonana nodokotela wazo. Nakuba i-preeclampsia iyisimo esiyingozi, ngokuvamile ixazulula izinsuku ezimbalwa kuya emasontweni ambalwa ngemva kokubeletha.
• Ezigulini ezine-proteinuria encane noma yesikhashana, imithi ingase ingadingeki.

Kwenzekani lapho kusolwa isifo sezinso noma esinye isimo?

Uma kusolwa isifo sezinso, inqubo yokuxilonga ibalulekile ukuze kuhlolwe okunembile nokungenelela kusenesikhathi:

• Phinda Ukuhlola Umchamo: Uma amaprotheni etholwa kumasampula omchamo phakathi nezinyanga ezintathu, lokho kuphakamisa isimo sezinso esingamahlalakhona, okugcizelela ukubaluleka kokutholwa kusenesikhathi.
• Ukuhlolwa kwe-Creatinine Clearance: Lokhu kuhlola amazinga e-creatinine kokubili emchameni nasegazini. Izinso ezinempilo zisefa i-creatinine, kodwa izinso ezikhubazekile ziyigcina egazini.
• Ukuhlolwa kwe-Glomerular Filtration Rate (GFR): Ikala ukusebenza kwezinso ngokucabangela izici ezifana neminyaka, ubukhulu, ubulili, nohlanga, isebenzisa amazinga e-creatinine ne-albumin egazini. I-GFR iqondisa ukuhlelwa kokwelashwa.
• Ukuhlolwa Kwegazi Okuphelele Kwe-Serum Protein: Hlola amaprotheni egazini ukuze uthole umbono ophelele wempilo yezinso.
• Izifundo ze-Imaging: Amasu afana ne-CT scans nama-ultrasounds asiza ukukhomba izinkinga zezinso ezifana namatshe, izimila, noma ukuvaleka komgudu womchamo.
• I-Urine Protein Electrophoresis (UPEP): Lokhu kuhlolwa kwelebhu kuhlukanisa amaprotheni athile omchamo kusetshenziswa imisinga kagesi.
• IUkuhlolwa Kwegazi kwe-mmunofixation (IFE): Ukuhlolwa kwegazi kuhlola amaprotheni athile, kusize ekuxilongeni.
• I-Kidney Biopsy: Isampula encane yezinso ihlaziywa ngesibonakhulu ukuze kutholakale imbangela yesifo kanye nezinga lomonakalo.

Kufanele ngimbone nini umhlinzeki wami wezempilo?

Thintana nodokotela wakho uma:

• ukuchama kaningi kunokuvamile noma uzwe ubuhlungu ngenkathi uchama
• ukuzwa ukuhlanza noma isicanucanu
• qaphela umchamo onegwebu noma onegwebu
• uzizwa ubuthakathaka, ikhanda elincane, noma isiyezi
• ube nokuvuvukala noma ukukhukhumala ebusweni bakho, esiswini, noma ngaphansi komzimba wakho
• ungabonisi noma yikuphi ukuthuthukiswa kwezimpawu ngemva kokwelashwa

Ngingayivimbela kanjani i-proteinuria?

Ayikho indlela yokuvimbela i-proteinuria, kodwa iyalawuleka. I-Proteinuria ingalawulwa ngokuphuza imithi, ukuthuthukisa indlela yokuphila, nokusebenzisa amakhambi asekhaya amaprotheni emchameni. Ukunakekela inkinga ewumsuka kuzosiza ukumisa ukulahleka kwamaprotheni emchameni.

Amanye amasu okuphatha i-proteinuria ahlanganisa:

• Ukunciphisa ukudla kwamaprotheni
• Ukwandisa i-fiber ekudleni
• Ukusebenzisa usawoti omncane ukusiza ukwehlisa umfutho wegazi
• Ukuzivocavoca okuvamile noma ukuvivinya umzimba
• Ukuqapha amazinga kashukela egazini njalo

Isiphetho

Abanye abantu abane-proteinuria bangase bangadingi ukwelashwa, njengoba ngezinye izikhathi kungaba okwesikhashana. Ukuba khona kwe-trace protein emchameni kubonisa i-proteinuria, evame ukusikisela a inkinga yezinso okuhlobene nokuhlunga kwegazi. Umgomo wokwelashwa uwukuxazulula noma yiziphi izinkinga umuntu angase abe nazo. Uma kunesidingo, udokotela angakha uhlelo lokusebenza ukuze avikele izinso futhi adambise noma yiziphi izimpawu ezihambisanayo.

Imibuzo Evame Ukubuzwa

1. Mangakanani amaprotheni emchameni evamile? 

Ngokuvamile akuyona inkinga uma imiphumela yokuhlolwa komchamo wakho ibonisa ama-milligrams angu-30 ngegremu (mg/g) yephrotheni noma ngaphansi, njengoba lokhu kubhekwa ngaphakathi kwebanga elivamile leprotheni yomchamo.

2. Ngingawalawula kanjani ngokwemvelo amaprotheni emchameni wami? 

Uma othile ebona izimpawu ze-proteinuria, ukudla kwakhe kufanele kube namaprotheni angu-15-20%. Kunconywa ukwandisa ukudla kwe-fiber nemifino emisha. Kunconywa ukuthi udle kuze kufike ku-55 amagremu we-fiber nsuku zonke.

3. Yikuphi ukudla okungcono kakhulu ekunciphiseni amaprotheni emchamweni? 

Imifino emisha kanye nefayibha kusekela imikhuba yamathumbu enempilo futhi kungase kunikeze isivikelo ezinhlotsheni ezithile zomdlavuza. Ukwengeza, bangasiza ukunciphisa amaprotheni emchameni.

CARE Medical Team

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