Chii chaunofanira kuziva nezve chisingaperi cheitsvo chirwere (uye nzira yekuzvidzivirira)

Dzidzo yehutano

Iwe wakacherekedza shanduko mune yako weti-kunge kuputika uye kupora furo - uye wanga uchizvimba nhasi, kunyanya kutenderedza makumbo ako. Zvimwe zvezviratidzo zvako zvinogona kutsanangurwa zviri nyore nemamiriro akajairwa, senge kushushikana, nhumbu, uye hutachiona, asi iro boka renyeredzi rezviratidzo rinogona kupihwa mhosva pachirwere chetsvo chisingaperi (CKD).

Chii chinonzi chronic kidney disease?

Yakarongerwa sekukuvadza kune itsvo dzako dzavepo kwemwedzi yakawanda, chirwere chetsvo chisingaperi chinoitika kana itsvo dzako dzakamira kushanda senge yakarongedzwa zvakanaka filtration system ivo ( kufamba kweropa, fluid, uye marara kuburikidza nemuviri wako 24/7).

Chirwere cheitsvo chakakomba, kana kukuvara kuri kupfava uye kwakaitika munguva pfupi yapfuura, kunogona kudzoserwa kana vanachiremba vakazvibata nenguva. Chirwere chetsvo chakanyanya chinobva chave chirwere chetsvo chisingaperi. Asi chirwere chetsvo chisingaperi chakaoma kupora-uye kukuvadza kune itsvo kazhinji chinhu chaungasaziva iwe unacho kusvika nguva yapera kupindira.

Chirwere chetsvo chisingaperi chiri kunyanya kuitika kupfuura iwe uchifunga. Zvinoenderana neUniversity of Missouri Health Care nephrologist Kunal Malhotra, MD, nyika nhamba dzinoratidza kuti 14% yevaAmerica vanayo, kusanganisira 1 muvatatu vanhu vane chirwere cheshuga, uye 1 muvashanu varwere vane yakakwira BP. Kuva neaya-kana ese ari maviri-ezvinhu izvo zvinoita kuti iwe ugove uine chirwere chisingaperi cheitsvo, sekuita semhuri nhoroondo yeitsvo matambudziko, kuva arterial vascular chirwere , kana kuve wedzinza reAfrica America.

Matanho echirwere chetsvo chisingaperi

Pane zvikamu zvishanu zvechirwere cheitsvo chisingaperi. Heano maitiro avanoputsa.

• Chikamu 1: Iwe unogona kunge uine zviratidzo zvekukuvara kweitsvo, kunge protein kana ropa mune yako weti, asi hazvisati zvichikanganisa itsvo dzako 'kushanda kwese.
• Chikamu chechipiri: Iwe unotanga kusangana nekumwe kurasikirwa kwekushanda, asi zvinogona kunge zvisingaonekwe parizvino kunze kwekunge chiremba wako aongorora GFR yako, kana glomerular filtration rate, inova chikamu cheyakajairika maelectrolyte murabhoritari kureva, yakakosha metabolic pani (BMP). Muvanhu vakuru vane hutano, GFR inofanira kunge iine makumi mapfumbamwe .
• Chikamu chechitatu: Basa rako reitsvo rinodonhera ku40% kana 50%. Uri kutanga kuunganidza maelectrolyte uye zvinoyerera, asi itsvo dzako dzichiri kushanda kuti dziwedzerwe pakurasikirwa kwebasa-saka iwe unogona kunge usati waziva nezve kukuvara.
• Chikamu 4: Sezvo itsvo yako ichienderera ichidzikira, haichakwanise kuvharidzira kushanda kwayo nemazvo. Iwe unotanga kuona zviratidzo sekuzvimba sezvo muviri wako unounganidza munyu uye potasium. Panguva ino, unogona kunzwa kuneta uye kuneta.
• Chikamu 5: Gare gare muchirwere, kana kushanda kwadzikira pazasi pe30%, unogona kurasikirwa nehavi, kuneta kana kushaya hope, kuoma uye kunhuwa kweganda, kuzvimba kwemaziso, kuzvimba kwemakumbo, makumbo, uye tsoka, tsandanyama dzemhasuru, kuita weti kakawanda, uye yakasviba kana furo weti (zviratidzo zvekuwedzera mapuroteni kana ropa murini). Kana itsvo dzako dzichishanda pa15% (kana zvishoma) zveyakajairika basa, ungangoda kuisirwa itsvo kana dialysis kudzivirira itsvo kutadza.

Chinhu chinonyengera pane chirwere chisingaperi cheitsvo, anodaro Dr. Malhotra, kungoenderera chinyararire.

Iwe unotanga kuve nekurasikirwa kwebasa muchikamu chechipiri, asi itsvo dzine nzira yekukunda izvo zvipingaidzo, anodaro Dr. Malhotra. Iyo inokambaira pamusoro pevanhu… kazhinji, hazvisi kusvika padanho rechina kuti iwe unonyatsocherechedza zviratidzo. Mune mamwe mazwi, kazhinji hazvizivikanwe kudzamara zvanyanyisa kumira kana kudzosera kukanganisa. Kune mashoma kwazvo zviratidzo zveyambiro mumatanho ekutanga auri kusangana nekuderera kwekushanda.

Haasi ese mashoko akaipa, asi: Pane zvinhu zvaunogona kuita kudzikamisa kufambira mberi kwechirwere chetsvo chisingaperi kana unacho uye, nekutenda, nzira dzekuzvidzivirira kuti zvisaitike pakutanga.

Kuongorora chirwere chisingaperi cheitsvo

Vanachiremba vanofungidzira chirwere chisingaperi cheitsvo muvarwere vavo vanowanzo mhanyisa kushanda kweropa kuti vatarise GFR uye kuita urinalysis kuyera imwe mhando yeprotein inonzi albumin . Ivo vanogona zvakare kuyera creatinine mazinga ; creatinine, chigadzirwa chemarara chinosvinwa neitsvo, chinowanzo kuunganidzwa kana itsvo ikadzikiswa. Sezvo chiyero chakajairika che creatinine chinosiyana nebonde, zera, uye mhasuru, mazinga e creatinine ari ega haakwanise kuongorora chirwere cheitsvo, kunyangwe chichigona kushandiswa pamwe chete neweti yekuongorora uye kuongorora kweGFR.

Aya mabvunzo bvunzo, kuwedzera kune ultrasounds uye biopsies yeitsvo, inogona kubatsira vanachiremba kuongorora kuvapo kwekukuvara.

Kurapa chirwere chisingaperi cheitsvo

Kana iri yekurapa, yakawanda yacho inovimba nehutano hwekuchinja mararamiro. Zvakakosha kugadzirisa zvinokonzeresa njodzi, sekuita shuwa kuti chirwere cheshuga chakanyatso chengetwa, pamwe nekuita shanduko yekudya, anodaro Dr. Malhotra.

Anowedzera kuti kudzikisira kushandisa kwako zvisina basa zvekuwedzera uye nemishonga (kunyanya pamusoro peiyo-the-counter anti-anogumbura zvinodhaka senge ibuprofen, inogona kukonzera kukuvara kwetsvo uye kuwedzera zviratidzo zvechirwere cheitsvo chisingaperi), pamwe nekurega kusvuta uye kurovedza muviri nguva dzose kunogona kudzivirira kumwe kukuvara kwetsvo kubva mukuitika.

Sekureva kwa Dr. Robert Greenwell, mukuru we nephrology paMercy Medical Center muBaltimore, kurapa BP uye imwe nzira yekudzivirira itsvo dzako kubva mukumwe kukuvara. Kudzora yako BP ne ACE inhibitor kana zvinodhaka senge losartan kana lisinopril inogona kubatsira iwe kuchengetedza itsvo kushanda uye kudzikisa huwandu hweprotein mumuti wako.

Nzira yekudzivirira chirwere cheitsvo

Dr. Greenwell anowedzera pasi pane kubatana pakati pechirwere chetsvo chisingaperi uye sarudzo dzemararamiro - kunyanya zvine chekuita nekudzivirira.

Kana isu taona yakasimbiswa, [kwenguva refu] kukuvadza kune itsvo, mukana wekuti isu tishandure izvo zvakaderera, anodaro. Asi kana tichitarisa pazvinhu zvikuru zvinoita kuti mumwe munhu ade dialysis, izvo zvinhu zvinowanzoenderana nemararamiro.

Anonongedzera kune zvakakwiririsa zvechirwere cheitsvo chisingaperi muvarwere vane chirwere cheshuga, hypertension, chirwere chemwoyo, HIV, pamusoro pekambani yeNSAID uye kushandisa zvinodhaka nguva zhinji: Zvinhu zvakawanda zvinokonzeresa chirwere cheitsvo chisingaperi uye zvinoguma nekukuvara zvachose kana kuda dialysis inogona 'hazvigadziriswe-asi isu tingadai takavadzivirira makore gumi nemashanu apfuura nesarudzo yekudya uye yemararamiro.

Saka chii chaunogona kuita izvozvi, usati wawana chirwere chetsvo chisingaperi, kuchengetedza itsvo dzako dzine hutano?

1. Chengetedza huremu hwako uye mashuga eropa. Kufutisa, insulini-kuramba, uye kukwirisa kweropa kunowanzo kutungamira kuchirwere cheshuga, chinova ndicho chinokonzera chirwere chetsvo chisingaperi. Kana chirwere cheshuga chisina kudzorwa neyakareba-yakamira Hemoglobin A1c pamusoro pe8.0%, iwe unofanirwa kutsvaga nyanzvi yeshuga senge endocrinologist kuti ubatsire nechirwere cheshuga chako sezvo chiri chikonzero chikuru chekusingaperi kweitsvo kukundikana muUnited States.
2. Rovedza muviri. Zvimwe zvidzidzo zvinoratidza kuti kurovedza muviri kunogona kunonoka kufambira mberi Yechikamu chechitatu uye chechina chirwere cheitsvo.
3. Rega kusvuta. Kusvuta kwete chete inowedzera njodzi yako yechirwere chetsvo chisingaperi , iyo inobatsira kune hypertension, kuomarara kweiyo renal arteri, uye proteinuria. Izvo zvakare zvine njodzi kupera chikamu renal chirwere (ESRD).
4. Idya zvakanaka. TO itsvo-inoshamwaridzika Kudya kwakazara muzviyo zvakakwana, mapuroteni emhuka akaonda uye mapuroteni anodyarwa, monounsaturated mafuta, michero, nyemba, uye miriwo zvinogona kudzivirira kukuvara kweitsvo, sekugona kudzora munyu, doro, uye mafuta akazara. Sangano reNational Institute of Diabetes uye Digestive uye Kidney Zvirwere (NIDDK) zvakare rinokurudzira vanhu vane chirwere chisingaperi cheitsvo kuti vatarise yakawanda sei phosphorus uye potasium iri mukudya kwavo , sezvo zvese zviri zviviri zvichibvira kuvaka muropa rako. Izvi zvinoreva: Dzivisa kudya mukaka wakawandisa, bhinzi yakawandisa, bhinzi, zvinwiwa zvine rima, mabhanana nemaorenji, pakati pezvimwe zvekudya. Sarudza yakaderera-phosphorus uye yakaderera-potasium chikafu senge maapuro, karoti, mukaka wemupunga, chena pasta, uye zvinwiwa zvakajeka kana zvichibvira.
5. Chengetedza mamiriro ezvinhu ehutano aripo. Kana iwe uine chirwere cheshuga, hypertension, kana hutachiwana hweHIV, ita shuwa kuti chiremba wako anogara achiongorora itsvo yako basa sezvo izvo zvirwere zvinowedzera mukana wako wekubatwa nechirwere cheitsvo.
6. Deredza kushandiswa kwemishonga. Vanhu vanotora maNSAID ekurwadziwa nemarwadzo asi havazive kuti mishonga iyi ndiyo inonyanya kukonzera kukuvara kwetsvo kunokonzerwa nezvinodhaka, anodaro Dr. Malhotra. Vanogona kukuvadza itsvo munzira dzakawanda, zvichikonzera mamiriro ekuzvimba ayo unokwanisa inodzoserwa-kunze kwekunge iwe wakazvitora kwenguva yakareba wakonzera kukuvara kusingadzoreke. Anokurudzira kungotora marwadzo eNSAID, senge naproxen kana ibuprofen, pazvinenge zvichidikanwa-uye nguva dzose uchitarisirwa nachiremba.
7. Iva mutsigiri akasimba wega. Kana uine chirwere cheshuga kana BP, chiremba wako anofanira kunge achiongorora itsvo yako ... uye kana asiri, unofanirwa kunge uchibvunza chiremba wako kuti itsvo dzako dziri kuita sei, anodaro Dr. Greenwell. Mune mamwe mazwi, kana iwe uchiziva kuti uri panjodzi yakanyanya yekukuvara kweitsvo nekuda kwechimiro chakatangira, usanyare nezvekuona kuti chiremba wako arikutarisa itsvo yako.
8. Tora vhitamini renal. Sekureva kweNational Kidney Foundation, chirwere chetsvo chisingaperi chinogona kukukonzera kugumira zvimwe zvekudya kana mapoka ezvikafu, zvinoreva kuti unogona kuve kushayikwa mune mamwe mavitamini akakosha uye zvicherwa . Kutora a renal vhitamini Unogona kuve nechokwadi chekuti uri kuwana izvo zvinovaka muviri - simbi, calcium, uye B yakaoma mavitamini - mazuva ese. Izvo zvakati, vanhu vane chirwere chisingaperi cheitsvo vanofanirwa zvakare kudzivirira kuva neyakawandisa yehumwe hutano, saka iwe unofanirwa kugara uchitaura nachiremba wako usati watora chero chinowedzera.

Unogona kudzoreredza kukuvara kweitsvo?

Iwe kazhinji haugone kudzoreredza chirwere cheitsvo chisingaperi nekuti kukuvara uye vanga rinowedzera. Mamwe mafomu echirwere cheitsvo chakakomba, senge rudzi rwunokonzerwa nekushandisa mishonga zvakanyanya, anogona kudzoserwa kana akabatwa nekukurumidza zvakakwana.

Pane imwe nguva [ini ndaona zviratidzo zvekukuvara], ndinofunga kuti zvingave zvichibva pachikonzero chakakomba uye chinogona kudzoserwa pakutanga, anodaro Dr. Greenwell. Kana iko kukuvara kuri kwazvino-kunge basa rako raive rakajairika mwedzi wapfuura uye izvozvi hazvisi - ndine mukana uri nani wekukubatsira iwe kupora pane kana uine kukuvara kwenguva refu.

Panguva iyoyo, Dr. Greenwell anotsanangura, zvishoma kutarisisa kunofanirwa kuiswa pakuedza kugadzirisa kana kurapa zvinokuvadza uyezve nezve nzira yekuzvidzora. Izvo chete kana iwe uri pasi peanenge gumi% mashandiro aunoda dialysis kana kuisirwa, anodaro. Saka unogona kunge uine chirwere chetsvo chisingaperi uye neyakajairika creatinine yevatatu, asi unogona kuzogara kwenguva refu kwenguva refu. Tinogona kuyedza kudzora kukuvara pasi, saka ako creatinine mazinga anowedzera pamusoro pemakore gumi nemashanu pane matatu.

Taura nemupi wako wezvehutano nezve nzira dzakanakisa dzekudzora kufambira mberi kwezvinetso zvako zveitsvo.