Matenda a diabetes nephropathy: Zizindikiro, magawo ndi chithandizo

Matenda a shuga ndi nephropathy ndimatchulidwe odziwika bwino a matenda a impso a shuga. Mawuwa amafotokoza zotupa za matenda a impso (glomeruli ndi tubules), komanso zombo zomwe zimawadyetsa.

Matenda a diabetes nephropathy ndi owopsa chifukwa amatha kumabweretsa gawo lotsiriza (lotha) kulephera kwa impso. Poterepa, wodwalayo adzafunika kupatsidwa dialysis kapena kupatsirana kwa impso.

Matenda a diabetes nephropathy ndi chimodzi mwazomwe zimayambitsa kufa koyambirira komanso kulemala kwa odwala. Matenda a shuga sikuti ndi okhawo omwe amachititsa vuto la impso. Koma pakati pa omwe akudwala dialysis ndikuyimirira pamzere wa impso wothandizira, ndiye wodwala kwambiri. Chimodzi mwazifukwa izi ndi kuchuluka kwakukulu kwa matenda ashuga a 2.

• Kuwonongeka kwa impso mu matenda a shuga, momwe amathandizira komanso kupewa
• Ndi mayeso ati omwe muyenera kudutsa kuti muwone impso (kutsegula pawindo lina)
• Zofunika! Zakudya za Impso za Matendawa
• Mitsempha yam'mimba
• Matenda a impso

Zifukwa zoyambitsa matenda a shuga:

• shuga wambiri wodwala,
• cholesterol yoyipa komanso triglycerides m'magazi,
• kuthamanga kwa magazi (werengani tsamba lathu la "mlongo" wa matenda oopsa),
• kuchepa kwa magazi, ngakhale “kofatsa” (hemoglobin m'magazi a odwala omwe ali ndi matenda ashuga) kuyenera kupita ku dialysis koyambirira kwa odwala omwe ali ndi matenda amtundu wina.

Poyamba kuyamba aimpso m'malo mankhwala (dialysis kapena impso kupatsidwa zina) odwala matenda a shuga:

• Kuchulukitsa kwa impso ndi 6.5 mmol / l), komwe sikungathe kuchepetsedwa ndi njira zochizira.
• Kusungika kwamadzimadzi m'thupi ndi chiopsezo chokhala ndi edema ya m'mapapo,
• Zizindikiro zodziwika za kuperewera kwa mphamvu m'thupi.

Zizindikiro zamagetsi oyesa magazi mwa odwala omwe ali ndi matenda a shuga omwe amathandizidwa ndi dialysis:

• Glycated hemoglobin - ochepera 8%,
• Magazi a hemoglobin - 110-120 g / l,
• Matenda a parathyroid - 150-300 pg / ml,
• Phosphorous - 1.13-11.78 mmol / L,
• Calcium yonse - 2.10-22,7 mmol / l,
• Zogulitsa Ca × P = Zochepera 4.44 mmol2 / l2.

Ngati matenda a impso amapezeka mwa odwala matenda ashuga okhudzana ndi dialysis, zotupa za erythropoiesis zimalembedwa (epoetin-alpha, epoetin-beta, methoxypolyethylene glycol epoetin-beta, epoetin-omega, darbepoetin-alpha), komanso mapiritsi a jekeseni kapena jakisoni. Amayesa kukhalabe ndi kuthamanga kwa magazi pansi pa 140/90 mm Hg. Art., ACE inhibitors ndi angiotensin-II receptor blockers amakhalabe mankhwala osankhidwa pochiza matenda oopsa. Werengani nkhani yakuti "Hypertension in Type 1 and Type 2 Diabetes" mwatsatanetsatane.

Hemodialysis kapena peritoneal dialysis iyenera kungotengedwa ngati gawo lokhazikika pokonzekera kupatsirana kwa impso. Pambuyo kumuyika kwa impso kwa nthawi yothandizidwa, wodwalayo amachiritsidwa kwathunthu chifukwa cha kulephera kwa impso. Matenda a diabetes a nephropathy akhazikika, kupulumuka kwa odwala kukuchulukirachulukira.

Pokonzekera kufalitsa kwa matenda a impso chifukwa cha matenda ashuga, madokotala akuyesayesa kuwona kuti zingatheke bwanji kuti wodwalayo azikhala ndi vuto la mtima (matenda a mtima kapena matenda opha ziwalo) mkati kapena pambuyo pa opaleshoni. Kuti izi zitheke, wodwalayo amapimidwa mayeso osiyanasiyana, kuphatikizapo ECG yokhala ndi katundu.

Nthawi zambiri zotsatira za mayesowa zimawonetsa kuti ziwiya zomwe zimadyetsa mtima ndi / kapena ubongo zimakhudzidwanso kwambiri ndi atherosulinosis. Onani nkhani "Renal Artery Stenosis" kuti mumve zambiri. Pankhaniyi, kupatsirana kwa impso, tikulimbikitsidwa kupangitsanso mwamphamvu kuchuluka kwa ziwiya izi.

Moni
Ndili ndi zaka 48, kutalika 170, kulemera 96. Ndinapezeka kuti ndadwala matenda a shuga 2 zaka 15 zapitazo.
Pakadali pano, ndimamwa piritsi ya metformin.hydrochlorid 1g m'mawa awiri ndi madzulo ndi januvia / sitagliptin / 100 mg piritsi limodzi madzulo ndiku insulin imodzi jekeseni patsiku lantus 80 ml. Mu Januwale adakumana ndi mayeso a mkodzo tsiku ndi tsiku ndipo mapuloteni anali 98.
Chonde dziwitsani mankhwala omwe ndingayambire kumwa impso. Tsoka ilo, sindingathe kupita kwa dokotala wolankhula Chirasha popeza ndimakhala kunja. Pali zambiri zotsutsana pa intaneti, chifukwa chake ndikhala wokondwa kwambiri yankho lake. Wokhulupirika, Elena.

> Chondealangizani
> Ndingayambire kutenga impso.

Pezani dokotala wabwino ndikumufunsira! Mutha kuyesa kuyankha funso ngati “kulibe” pokhapokha ngati mwatopa ndi moyo.

Masana abwino Chidwi cha mankhwala a impso. Mtundu woyamba wa shuga. Kodi ndi ma donki ati omwe akuyenera kuchitika kapena chithandizo chikuyenera kuchitika? Ndadwala kuyambira mu 1987, kwa zaka 29. Ndimakondanso kudya. Ndingakonde. Anachita ndi oponya, Milgamm ndi Tiogamm. Kwa zaka 5 zapitazi sanakhale m'chipatala chifukwa cha endocrinologist wa chigawo, yemwe amangokhalira kunena kuti izi ndizovuta kuchita. Kupita kuchipatala, muyenera kuti simumva bwino. Kudzikuza kosasamala kwa adotolo, omwe ali ofanana kwathunthu.

> Kodi oponya amafunika kuchita chiyani
> kapena kuchitira mankhwala?

Phunzirani nkhani ya “Impso Zakudya” ndipo onani momwe akunena. Funso lalikulu ndilakuti muyenera kutsatira zakudya ziti. Ndipo otsitsa ndi apamwamba.

Moni. Chonde yankhani.
Ndili ndi zotupa kumaso (masaya, matope, masaya). M'mawa, masana ndi madzulo. Mukapanikizika ndi chala (ngakhale pang'ono), ma denti ndi maenje amakhalapo omwe samapitilira nthawi yomweyo.
Atasenda impso, kuwunika kwa ultrasound kunawonetsa mchenga mu impso. Amati amwe madzi ambiri. Koma kuchokera ku "madzi ochulukirapo" (ndikamamwa zoposa 1 lita imodzi patsiku) ndimatupa kwambiri.
Ndikayamba kudya zakudya zamagulu ochepa, ndinamvanso ludzu. Koma ndimayesetsa kumwa 1 lita imodzi, monga momwe ndidayendera - nditatha kutalika kwa malita 1.6.
Pa chakudya ichi kuyambira pa Marichi 17. Sabata yachinayi yapita. Pomwe kutupako kuli pamalo, ndipo kulemera ndikuyenera. Ndidakhala pachakudyachi chifukwa ndimafunika kuchepa thupi, kuchotsera kumva kutupa kokwanira, ndikuchotsetsa ziphuphu m'mimba mwanga nditatha kudya chakudya chamafuta.
Chonde ndiuzeni momwe ndingawerengere moyenera manambala anu akumwa.

> momwe mungawerengere mndandanda wa zakumwa zanu

Choyamba, muyenera kuyesa magazi ndi mkodzo, kenako kuwerengetsa kuchuluka kwa kusefukira kwa impso (GFR). Werengani tsatanetsatane apa. Ngati GFR ili pansipa 40 - chakudya chamafuta ochepa sichimaletsedwa, zimangoyambitsa chitukuko cha kulephera kwa impso.

Ndimayesetsa kuchenjeza aliyense - yesetsani kuyesa ndikuwona impso zanu musanadye zakudya zamagulu ochepa. Simunachite izi - mwapeza zotsatira zofanana.

> Kuyesa impso, kuwunika kwa ultrasound kudawonetsa

Choyamba, muyenera kutenga kuyesa kwa magazi ndi mkodzo, komanso ma ultrasound pambuyo pake.

ndi mapuloteni otere mumadzutsa alamu mwachangu! Ngati dokotala wanena monga: - "Ukufuna chiyani, ndi matenda anu a shuga. ndipo odwala matenda ashuga nthawi zonse amakhala ndi mapuloteni ”amathawa kwa dotolo osayang'ana kumbuyo! osadzabweranso zamtsogolo mayi anga. mapuloteni sayenera kukhala konse. muli kale ndi matenda a shuga. ndipo tonse timakonda kuchitira monga mwa nthawi zonse nephropathy. diuretic mu Mlingo wa kavalo. koma amakhala osathandiza, ngati alibe ntchito. Kuvulaza kwa iwo ndikokulirapo. zolemba zambiri za endocrinology zimalemba za izi. koma madotolo mwachiwonekere adagwira zolemba izi nthawi ya maphunziro awo, adalemba mayeso ndikuyiwala. chifukwa chogwiritsa ntchito diuretics, creatinine ndi urea nthawi yomweyo zimawonjezeka kwambiri. Muyamba kutumizidwa ku hemodialysis yolipira. mudzayamba kukhala ndi edema yoyipa. kukakamizidwa kumawuka (onani triad of virchow). gwiritsani ntchito ma captopres / Captopril kapena zoletsa zina za ACE. mitundu yonse. Mitundu ina yamtundu wa mankhwala a antihypertensive ingayambitse kuwonongeka kwakukuru m'moyo wathanzi. mwina sizingasinthe. Osakhulupirira madotolo! m'magulu! onani ndikufananiza nthawi iliyonse ndi zomwe zalembedwa m'mabuku a endocrinology. ndipo kumbukirani. ndi matenda ashuga, chithandizo chovuta cha mankhwala chokha chikuyenera kugwiritsidwa ntchito. mothandizidwa ndi "ziwalo zomwe mukufuna." zonse. kuthawa ndi dokotala wochita monotherapy akadali wamoyo. zomwezo zimapita kwa dokotala yemwe samadziwa kuti alpha lipoic acid ndi wodwala matenda ashuga. komaliza. Pezani gulu la anthu odwala matenda ashuga pa intaneti ndipo pezani gawo lanu. Madokotala kulikonse amasambira kwambiri pankhani izi. kwa okodzetsa aliwonse (okodzetsa), kupezeka kwa nephropathy iliyonse ndi kutsutsana. ndikuweruza malinga ndi kufotokozera kwanu, sizotsika kuposa gawo 3. Ganizirani kokha ndi mutu wanu. apo ayi udzayimbidwa mlandu wonyalanyaza matendawa. kotero, monga akunena, chipulumutso cha kumira, ntchito zamanja kodi mukudziwa ndani ...

Moni. Ndiuzeni zomwe ndingachite ndi zizindikiro za ketone mumkodzo zomwe zimawoneka ndi chakudya chamafuta ochepa, ndipo ndizowopsa bwanji?

Zikomo chifukwa cha ntchito yanu ya titanic komanso kuunikiridwa kwathu. Uwu ndiye chidziwitso chabwino kwambiri paulendo wautali pa intaneti. Mafunso onse aphunziridwa ndikuwonetsedwa mwatsatanetsatane, zonse ndizomveka komanso zopezeka, komanso mantha komanso kuopa kuzindikira komanso kusayang'anira kwa madotolo adatseguka kwinakwake.)))

Moni Koma bwanji za kadyedwe ngati pali mavuto a impso? M'nyengo yozizira, pa kabichi limodzi ndi mavitamini simungathe kupitako