Ukwehluleka Kwesibindi Okubucayi

Ukwelashwa Kokwehluleka Okubi Kwezinso e-Hyderabad, e-India

I-Acute Renal failure, eyaziwa nangokuthi ukwehluleka kwezinso okukhulu, kuyisimo sezempilo lapho izinso zakho ziyema khona ngokuzumayo ukwenza umsebenzi wazo ovamile wokuhlunga udoti. Lokhu kungaholela ekuqongeleleni udoti omningi okubangela ukungalingani ekwakhekeni kwamakhemikhali egazi. Ngokuvamile kubonakala kubantu abaphethwe yisifo esibucayi. 

Ukwehluleka kwezinso okukhulu kungaba yingozi uma kungelashwa ngesikhathi esifanele. Ngenxa yentuthuko yesayensi yezokwelapha, ukwehluleka kwezinso okukhulu kungelashwa. Futhi uma ungumuntu ophila ngendlela enempilo futhi unempilo enhle, ukululama kwakho kungase kusheshe futhi izinso zakho ziqale ukusebenza ngendlela evamile. 

Izimbangela Zokwehluleka Okunamandla Kwezinso

Ukwehluleka kwezinso okukhulu kungenzeka ngaphansi kwezimo ezilandelayo:

• Ukuncipha kokugeleza kwegazi ezinso ngenxa yesimo sempilo esicashile.
• Ukulimala okuqondile noma ukulimala ezinso.
• Ukuvaleka kwamashubhu okukhipha umchamo (ureters) ezinso, ukuvimbela ukuchithwa kwemfucuza ngomchamo.

Izimpawu Zokwehluleka Kwezinso Okubi 

I-Acute Renal Failure ikhombisa izimpawu ezimbalwa. Kubaluleke kakhulu ukuqaphela lezi zimpawu futhi uthintane nodokotela kusenesikhathi.

Izimpawu ze-Acute Renal Failure zimi kanje:

• Ukuncipha kokukhishwa komchamo

• Ubunzima bokuphefumula

• Ukushintsha kwemizwelo njalo

• Isifiso esibi

• Ukukhathala noma ukukhathala

• Ukuvuvukala kwemilenze, amaqakala, noma eduze kwamehlo

• Ubuhlungu esifubeni noma ingcindezi

• Isicanucanu noma ukuhlanza izinsuku eziningi

• Igazi lilandela indle

• Umfutho wegazi ophezulu

• Ukuquleka, ukudlikiza, noma ukundindizela kwesandla. Ikhoma ezimeni ezinzima

Izikhathi eziningi umuntu onenkinga yokuhluleka kwezinso okukhulu angase angabonisi zimpawu. Ezimweni ezinjalo, kungatholwa ngokuxilongwa ochwepheshe bezokwelapha kuphela.

Izigaba Zokwehluleka Okubi Kwezinso 

Ukwehluleka kwe-acute renal, okubuye kwaziwe ngokuthi i-acute kidney injury (AKI), yisimo esibonakala ngokwehla okungazelelwe nokusheshayo ekusebenzeni kwezinso. Ngokuvamile kunezigaba ezintathu ekuqhubekeni kokuhluleka kwe-renal acute:

• Isigaba 1- Isigaba Sokuqala noma Sokuqala: Lesi yisigaba sokuqala lapho kuba khona isigameko esibangela ukwehla ngokushesha ekusebenzeni kwezinso. Isizathu esiyinhloko kungaba izimo ezinjengokuphelelwa amanzi kakhulu emanzini, ukunciphisa ukugeleza kwegazi ezinso, noma ukulimala okuqondile kwezicubu zezinso. Phakathi nalesi sigaba, ikhono lezinso lokuhlunga udoti nokulawula ama-electrolyte liyaphazamiseka.
• Isigaba 2- Isondlo noma Isigaba se-Oliguric: Kulesi sigaba, kukhona ukuncipha okuphawulekayo kokukhishwa komchamo (oliguria), ngokuvamile okuchazwa ngokuthi ngaphansi kwama-milliliters angu-0.5 ngekhilogremu yesisindo somzimba ngehora. Lesi sigaba singahlala kusukela ezinsukwini kuya emavikini. Izinso ziyazabalaza ukugcina uketshezi, ama-electrolyte, kanye nemfucuza emzimbeni. Ngenxa yalokho, kungase kube nokunqwabelana kobuthi nemikhiqizo engcolile, okuholela ezimpawu ezifana nokugcinwa koketshezi, ukungalingani kwe-electrolyte, kanye ne-uremia.
• Isigaba 3- Ukubuyisela noma Isigaba Se-Diuretic: Phakathi nesigaba sokululama, izinso ziqala ukubuyisela ukusebenza. Ukukhipha umchamo kuyenyuka, futhi kuba ngcono kancane kancane ekuhlungeni nasekukhishweni kwemfucuza. Lesi sigaba singahlala amasonto kuya ezinyangeni. Nokho, ukusebenza kwezinso kungase kungabuyeli kwesejwayelekile ngokugcwele, futhi abanye abantu bangase baqhubeke nokuba nokukhubazeka okusalayo.

Kungani Kwenzeka Ukwehluleka Okubukhali Kwezinso?

I-Acute Kidney Failure ingenzeka ngenxa yezizathu eziningi. Kungenzeka ngenxa yalokhu okulandelayo: 

Ukunciphisa Ukugeleza Kwegazi

Ezinye izifo zinganciphisa ukugeleza kwegazi lakho. Ngokuvamile kuba umphumela wokuvaleka ingxenye noma okuphelele kwemithambo yenhliziyo. Izifo ezinjalo ezingabangela ukwehluleka kwezinso kungazelelwe ngaleyo ndlela ziholele ku-ARF yizi:

• I-Hypotension okungukuthi umfutho wegazi ophansi

• Ukulahlekelwa yigazi noma uketshezi okubangelwa izinkinga ezifana nokopha, isifo sohudo esinzima

• Ukwehluleka kwezinye izitho ezifana nesibindi, inhliziyo, njll.

• Ukusetshenziswa ngokweqile kwezidakamizwa ezingezona ukuvuvukala (ama-NSAID) ezisetshenziselwa ukudambisa izinhlungu

• Noma yikuphi ukuhlinzwa okukhulu

Ukulimala Okuqondile Ezinso

Ezinye izifo noma izimo zingalimaza ngqo izinso zakho okungase kuholele ekuhlulekeni okukhulu kwezinso. Lokhu kubandakanya:

• I-Sepsis yisimo esisongela ukuphila esingaholela ku-ARF

• I-Multiple myeloma wuhlobo lomdlavuza olungaholela ekuhlulekeni kwezinso okukhulu

• Isimo sezempilo esibizwa ngokuthi i-vasculitis sibangela ukuvuvukala kanye nezibazi zemithambo yegazi.

• Noma yisiphi esinye isimo sezokwelapha esingalimaza ngokuqondile noma sibangele ukuvuvukala kumashubhu ezinso, imithambo yegazi emincane ezinso, noma amayunithi okuhlunga ezinso. 

Ukuvinjwa Kwepheshana Lomchamo

I-Urinary Tract kanye nezinso nezinye izitho zakha ingxenye ebalulekile yesistimu yokukhipha indle. Ngakho ukuvaleka komgudu womchamo kungaholela ekuhlulekeni okukhulu kwezinso. Ezinye zezimo okungenzeka ngenxa yazo ukuvinjelwa zimi kanje:

• Umdlavuza wesinye, womlomo wesibeletho, noma wendlala yesinye

• Izinkinga ku-prostate njengokwandiswa kwayo

• Amatshe ezinso

• Ukuba khona kwamahlule egazi emgudwini womchamo 

Izinhlobo Zokwehluleka Okubi Kwezinso

I-Acute Renal Failure ingahlukaniswa ngezinhlobo ezintathu - prerenal, renal, ne-postrenal. Lokhu kuhlukaniswa kusekelwe phezu kwezimbangela ngenxa yalokho okwenzeka kwasekuqaleni.

• I-Acute Prerenal Failure: Kubangelwa lapho ukutholakala kwegazi ezinso kuncipha. Kubonwa cishe kumaphesenti angama-60 kuye kwangama-70 azo zonke izimo ze-ARF. 
• Ukwehluleka Okukhulu Kwezinso (Intrinsic).: Lolu hlobo lwe-ARF lubangelwa ukulimala okuqondile noma ukulimala kwezinso. Lokhu kungenzeka ngenxa yamahlule egazi, i-Lupus, ukusetshenziswa kabi kwezidakamizwa, njll.  
• I-Acute Postrenal Failure: Kwenzeka uma kuvimbekile emgudwini womchamo. Izimbangela ze-postrenal zenza amaphesenti angu-5 kuya kwangu-10 azo zonke izimo ze-ARF. 

Izingozi Ezihilelekile Ekuhlulekeni Okukhulu Kwezinso

Ukwenzeka Kokwehluleka Kwezinso Okukhulu (ARF) kubonakala kakhulu ezimeni lapho umuntu esevele enezinye izimo zezokwelapha. Lezi zimo zivame ukwandisa ubungozi bokuthola i-ARF. 

Izimo ezingandisa ingozi ye-ARF yilezi ezilandelayo:

• Ukulaliswa esibhedlela ngenxa yezimo ezithile zezempilo ezibucayi ezidinga ukunakekelwa okukhulu

• Ukuguga kungandisa ingozi ye-ARF

• Ukukhuluphala ngokweqile kungabangela ukucindezeleka okukhulu ezinso. Lokhu kungaholela ekuthuthukisweni kwe-ARF

• Isifo sikashukela esingalawuleki singalimaza imithambo yegazi yezinso. Ngokuhamba kwesikhathi lokhu kungalimaza izinso futhi kuholele ekuhlulekeni kwazo.

• Ukuba khona kwe-coronary artery disease

• Izifo zesibindi

• Izifo zezinso

• Ezinye izinhlobo zomdlavuza kanye nokwelashwa okuhambisana nazo

• Ukuhluleka kwenhliziyo 

Ukuxilongwa Kokwehluleka Okukhulu Kwezinso

Ngemva kokuhlola izimpawu nezimpawu eziboniswa nguwe, udokotela wakho angase asikisele ukuhlolwa okuningana ukuze aqinisekise ukwenzeka Kokwehluleka Okubi Kwezinso. Lokhu kungaqinisekiswa ngosizo lokuxilongwa okufanele. 

Ukuxilongwa kwe-Acute Renal Failure kufaka phakathi ukuhlolwa nezinqubo ezilandelayo: 

• Ukulinganisa Okukhipha Umchamo: Kulokhu kuhlolwa, ukuphuma komchamo kukalwa ngamahora angama-24. Lokhu kusiza odokotela ekuhloleni ukusebenza kwezinso.  

• Ukuhlola Umchamo Isampula: Ukuhlaziywa kwesampula yomchamo kuyenziwa. Lokhu kungase kusize odokotela ekuqondeni okungavamile okungenzeka kube khona ohlelweni lokukhipha indle.

• Ukuhlolwa kwegazi: Ukuhlaziywa kwamasampula egazi kuzosiza ekutholeni amazinga anyukile e-urea ne-creatinine. Lezi yizibi ezimbili ezikhona egazini futhi zisiza ekuhloleni isimo sezinso.

• Izivivinyo zokuzicabangela: Ukuhlolwa okufana ne-CT scans noma ukuhlolwa kwe-ultrasonography kuzosiza ukuqonda ukuthi ingabe kukhona ukuvaleka ekugelezeni komchamo wakho noma uma izinso zakho zikhulisiwe. 

• Ukuhlolwa Kwezicubu zezinso: Kwezinye izimo, udokotela angase enze i-biopsy yezinso ukuze aqale Ukwelashwa Kokwehluleka Kwezinso. Lokhu kwenziwa ukuze kukhishwe ucezu oluncane lwezicubu zezinso. Lokhu kungase kubasize babone ubulukhuni bokuhluleka kwezinso futhi baqaphe ukwelashwa okunikezwayo kokwehluleka kwezinso. 

Ukuvimbela Ukwehluleka Okubi Kwezinso

Ukuhluleka kwezinso okukhulu kuvame ukuba yinselele ukulindela noma ukukuvimbela, kodwa ungathatha izinyathelo zokunciphisa ingozi ngokunakekela izinso zakho. Cabangela lokhu okulandelayo:

• Qaphela ngemithi yobuhlungu etholakala ngaphandle kwekhawunta (OTC) ngokufunda amalebula ngokucophelela. Namathela eziqondisweni ezinconyiwe zokudambisa izinhlungu ze-OTC njenge-aspirin, i-acetaminophen (Tylenol), ibuprofen (Advil, Motrin), ne-naproxen sodium (Aleve). Ukusebenzisa le mithi ngokweqile kungandisa ingozi yokulimala kwezinso, ikakhulukazi uma unezimo ezivele zikhona ngaphambili njengesifo sezinso, isifo sikashukela, noma umfutho wegazi ophakeme.
• Hlanganyela nodokotela wakho ukuze ulawule izimo ezingalapheki, okuhlanganisa nezinkinga eziphathelene nezinso. Uma unezimo eziphakamisa ingozi yokwehluleka kwezinso okukhulu, njengesifo sezinso, isifo sikashukela, noma umfutho wegazi ophakeme, namathela ezinhlelweni zokwelapha futhi ulandele iseluleko sikadokotela wakho ukuze ulawule impilo yakho ngokuphumelelayo.
• Beka kuqala indlela yokuphila enempilo ngokuhlala uvivinya umzimba, udle ukudla okunomsoco, futhi uphuze utshwala ngokusesilinganisweni noma uzigweme ngokuphelele uma kungenzeka.

Ukwelashwa Kokwehluleka Okubi Kwezinso

Ukwehluleka Okukhulu Kwezinso Ukwelashwa ngesikhathi esifanele kungasindisa impilo yomuntu. Ukwelashwa kwe-Acute Renal Failure kuhlanganisa lokhu okulandelayo: 

• Uketshezi olufakwa emthanjeni uma i-ARF ibangelwa ukuntuleka koketshezi egazini lakho. Odokotela bangase batuse imithi uma ukuhluleka kwezinso okukhulu kubangela ukuba ube noketshezi oluningi  

• Imithi yokulawula amazinga e-potassium egazini lakho. Lokhu kuzokwenziwa uma izinso zakho zingayihlungi kahle i-potassium egazini lakho. 

• Imithi yokubuyisela amazinga e-calcium egazini. Lokhu kuzokwenziwa uma i-calcium iphansi kakhulu egazini lakho. 

• I-Hemodialysis Uma ubuthi bukhula egazini lakho isikhathi eside. Lokhu kuzosiza ekukhipheni ubuthi noketshezi okweqile emzimbeni wakho ngenkathi izinso zakho zilulama. I-Dialysis inqubo lapho umshini umpompa igazi ngaphandle komzimba ngosizo lwenso yokwenziwa.

Izibhedlela ze-CARE yaziwa ngobungcweti bazo ekwelapheni izifo ezithinta izinso eziyinkimbinkimbi kakhulu, okuhlanganisa nokwelashwa kokwehluleka kwezinso eHyderabad nakwezinye izikhungo. Ezibhedlela ze-CARE siphinde sinikeze ukwelashwa okunamandla kwezinso e-Hyderabad, kanye nokwelashwa kokwehluleka kwezinso okukhulu e-Hyderabad futhi siyaqonda ukuthi iziguli ezinesifo sezinso zidinga ukunakekelwa kwekhwalithi, isiqondiso nethemba. Sinabanye abahamba phambili i-nephrologists eNdiya, abasebenza eduze nabelaphi bomzimba nabasebenzi ukuze bakhe uhlelo lokwelapha oluphelele, lomuntu ngamunye, bekhumbula ukuxilonga kwesiguli, indlela yokuphila, nezimfuneko zobungcweti.

Izibhedlela ze-CARE zihlinzeka ngohlu olugcwele lwezinsizakalo zokuqinisekisa ukuthi imiphumela engcono kakhulu ifinyelelwa odokotela bethu ezinhlobonhlobo zezifo ezisukela ekuzalweni kuye kokutholwayo neziwohlokayo. Odokotela bethu be-nephrologist bahlanganisa ngokuphelele zonke izici zokwelapha, okuhlanganisa ukungenelela kusenesikhathi, ukwesekwa kokufakelwa kabusha, kanye nezinsizakalo zokuhlanza igazi, njenge-peritoneal dialysis (CAPD) kanye nocwaningo lomtholampilo.