Iyi ngingo yeguriwe ba nyiri amatungo bose bafata amatungo yabo yihanganye kandi yitonze. Nubwo bagiye, bazumva urukundo rwawe.

01 umubare wamatungo ufite kunanirwa kwimpyiko uragenda wiyongera uko umwaka utashye

Kunanirwa kw'impyiko gukabije birashobora guhinduka igice, ariko kunanirwa kw'impyiko karande ntigusubira inyuma rwose. Abafite amatungo barashobora gukora ibintu bitatu gusa:

1: Kora akazi keza mubintu byose byubuzima, kandi ugerageze kutareka amatungo agira impyiko usibye impanuka;

2: Kunanirwa gukabije kw'impyiko, gusuzuma hakiri kare, kuvura hakiri kare, ntutindiganye, ntutinde;

3: Kera kunanirwa kw'impyiko karande kuboneka no kuvurwa, igihe cyo kubaho ni kirekire;

02 Kuki kunanirwa kw'impyiko bigoye gukira

Hariho impamvu zibiri zingenzi zituma kunanirwa kw'impyiko biteye ubwoba kandi bigoye kuvura:

1: Nkuko byavuzwe mbere, usibye ko kunanirwa gukabije kwimpyiko guterwa nuburozi na ischemia yaho bishobora guhinduka, ibisigaye ntibisubirwaho. Iyo imvune nyayo yimikorere yimpyiko igoye gukira, kandi nta muti nyawo wo kunanirwa kwimpyiko ku isi, byose ni intungamubiri ninyongera;

2: Twese tuzi ko impyiko ari urugingo rwabitswe mumubiri, ni ukuvuga ko dufite impyiko ebyiri. Niba imwe yangiritse, umubiri urashobora gukora mubisanzwe, kandi ntituzumva indwara. Impyiko yerekana ibimenyetso gusa mugihe hafi 75% yimikorere yabuze, niyo mpamvu kunanirwa kwimpyiko bitinda cyangwa bitinze iyo bibonetse, kandi hariho uburyo buke bwo kuvura burahari.

Iyo imikorere yimpyiko yatakaye 50%, ibidukikije byimbere birahagaze neza, kandi ntibishoboka kumenya ibibazo; Gutakaza imikorere yimpyiko ni 50-67%, ubushobozi bwo kwibandaho buratakara, agaciro ka biohimiki ntigahinduka, kandi umubiri ntuzerekana imikorere, ariko ibizamini bimwe na bimwe byateganijwe, nka SDMA, biziyongera; Gutakaza imikorere yimpyiko byari 67-75%, kandi nta mikorere yagaragaye mumubiri, ariko azote ya biohimiki urea azote na creinine byatangiye kwiyongera; Kurenga 75% byimikorere yimpyiko bisobanurwa nko kunanirwa kwimpyiko na uremia yateye imbere.

Ikigaragara cyane cyo kunanirwa gukabije kwimpyiko nigabanuka ryihuse ryinkari zinyamanswa, niyo mpamvu nsaba buri nyiri amatungo kureba inkari zamatungo ye buri munsi. Ibi biragoye cyane kubafite amatungo bakunze kureka injangwe nimbwa gusohoka mubwisanzure, kubwibyo rero nigihe kinini cyanyuma kugirango aya matungo arwarwe.

03 abarwayi bamwe bafite ikibazo cyimpyiko zikomeye barashobora gukira

Nubwo kunanirwa gukabije kwimpyiko kunanirwa kwimpyiko byatangiye vuba nibimenyetso bikaze, biracyashoboka gukira, bityo rero ni ngombwa cyane kwirinda ko habaho kunanirwa gukabije kwimpyiko no gushaka icyateye indwara. Kunanirwa kw'impyiko ahanini biterwa na ischemia yaho, guhagarika inkari hamwe n'uburozi.

Kurugero, 20% byamaraso kumutima ni kumpyiko, mugihe 90% yamaraso yimpyiko anyura mumyanya yimpyiko, iki gice rero kibasirwa cyane na ischemia nuburozi buterwa no kwangirika. Kubwibyo, akenshi dusanga indwara zimpyiko numutima akenshi zifitanye isano. Iyo kimwe ari kibi, urundi rugingo ruzagira intege nke kandi rushobora kwandura indwara. Impamvu zikunze gutera impyiko ziterwa na ischemia zirimo umwuma mwinshi, kuva amaraso menshi no gutwikwa.

Niba umwuma, kuva amaraso no gutwika bitoroshye kubaho, gutera cyane kunanirwa kw'impyiko zikomeye mubuzima bwa buri munsi ni kunanirwa gukabije kw'impyiko biterwa no guhagarika inkari. Akenshi ni uruhago n'amabuye yinkari, guhagarika kristu, urethritis, kubyimba no guhagarika catheter yinkari. Guhagarika bitera kwirundanya k'inkari, guhagarika filtrike ya glomerular, kongera azote itari proteyine mumaraso, bikaviramo globeular basement membrane necrosis. Ibi biroroshye kubyumva. Igihe cyose inkari zifunze amasaha arenga 24, tugomba gusuzuma ibinyabuzima kugirango tumenye ko hatabaho kunanirwa kw'impyiko. Ubu bwoko bwo kunanirwa kw'impyiko nabwo bwonyine kunanirwa kw'impyiko bishobora gukira burundu muminsi mike, ariko biramutse bitinze, birashoboka ko byongera indwara cyangwa bigahinduka kunanirwa kw'impyiko zidakira muminsi mike.

Ubwoko butandukanye bwo kunanirwa kw'impyiko buterwa n'uburozi. Kurya inzabibu burimunsi nimwe, kandi ibyinshi ni ugukoresha nabi ibiyobyabwenge. Mu mazi na electrolyte ya reabsorbed glomerular filtration fluid, selile tubular epithelial selile ihura nuburozi bwuburozi. Isohora cyangwa reabsorption yuburozi na selile tubular epithelial selile irashobora gutuma uburozi bwirundanya cyane muri selile. Rimwe na rimwe, uburozi bwa metabolite burakomeye kuruta ubw'ibintu byabanjirije. Ibiyobyabwenge byingenzi hano ni "gentamicin". Gentamicin ni imiti ikunze gukoreshwa na gastrointestinal anti-inflammatory, ariko ifite nephrotoxicity. Kenshi na kenshi, ndetse no mu bitaro, niba gusuzuma no kuvura bidakwiye, biroroshye gutera uburozi buterwa no kunanirwa gukabije kw'impyiko.

Ndasaba cyane ko banyiri amatungo bagerageza kudatera gentamicin mugihe bafite amahitamo. Byongeye kandi, inyamanswa zifite impyiko mbi zigomba kwitondera imiti. Imiti myinshi igabanya ubukana izerekana impyiko zidahagije mu kwirinda. Koresha witonze, cephalosporine, tetracyclines, antipyretics, analgesics, nibindi.

04 kunanirwa kw'impyiko bidakira bikenera ubuvuzi bw'abarwayi

Bitandukanye no kunanirwa gukabije kwimpyiko, kunanirwa kwimpyiko zidakira biragoye kubibona, kandi nta bimenyetso bigaragara mugihe cyambere cyo gutangira. Ahari hazaba inkari nyinshi zirenze izisanzwe, ariko ntidushobora gucira urubanza mubuzima bwacu bwa buri munsi ko biterwa no kwiyongera kwinshi kwinkari ziterwa nikirere gishyushye, ibikorwa byinshi nibiryo byumye. Byongeye kandi, biragoye kumenya icyateye impyiko zidakira. Kugeza ubu, icyakoreshwa nk'icyerekezo ni indwara z'isi, nka nephritis, nephropathie genetique ivuka, inzitizi zo mu nkari, cyangwa kunanirwa kw'impyiko zidakira zitavuwe ku gihe.

Niba kunanirwa kw'impyiko bishobora nanone kwihutisha gukira hongerwa itangwa ry'amazi yo kunywa, gutera inshinge munsi y'amazi, dialyse n'ubundi buryo bwo guhinduranya uburozi no kugabanya umutwaro ku mpyiko. Nta buryo bwo kugarura imikorere yimpyiko kunanirwa kwimpyiko zidakira. Gusa icyo dushobora gukora ni ukugabanya umuvuduko wo gukomeretsa impyiko no kongera ubuzima bwamatungo binyuze mu kugaburira siyanse hamwe nintungamubiri zimwe na zimwe, nk'inyongera ya calcium, gukoresha erythropoietin, kurya ibiryo byandikiwe no kugabanya poroteyine. Ikindi ugomba kumenya nuko kunanirwa kwimpyiko byinshi bizajyana no kugabanuka kwimikorere ya pancreatic, ndetse na pancreatitis, nayo ikeneye kwitabwaho.

Inzira nziza yo guhangana nimpyiko zidakira ni ukubibona hakiri kare. Iyo ibonetse kare, niko ubuzima bwiza bushobora kubungabungwa. Ku njangwe, iyo ibizamini bya biohimiki ya azote ya urea, creinine na fosifore ari ibisanzwe, SDMA irashobora kugenzurwa buri gihe rimwe mu mwaka kugirango hamenyekane niba hari impyiko zidakira zidakira. Nyamara, iki kizamini ntabwo ari ukuri ku mbwa. Mu mwaka wa 2016 muri Amerika ni bwo twatangiye kwiga niba iki kizamini gishobora gukoreshwa ku mbwa. Kuberako agaciro k'ibizamini gatandukanye cyane ninjangwe, ntishobora gukoreshwa nkigipimo cyo gusuzuma imbwa mugihe cyambere cyo kunanirwa kw'impyiko zidakira. Kurugero, 25 ni iherezo ryicyiciro cya 2 cyangwa nintangiriro yicyiciro cya 3 cyo kunanirwa kwimpyiko zidakira ku njangwe, Ku mbwa, intiti zimwe zemeza ko no mubuzima.

Kunanirwa kw'impyiko z'injangwe n'imbwa ntibisobanura urupfu, bityo abafite amatungo bagomba kubitaho bihanganye kandi bitonze bafite amahoro. Ibisigaye biterwa nigihe cyabo. Injangwe nahaye bagenzi banjye mbere wasangaga ifite ikibazo cyo kunanirwa kw'impyiko zidakira afite imyaka 13. Yagaburiwe mu buhanga n'ibiyobyabwenge ku gihe. Mugihe cyimyaka 19, usibye gusaza kwamagufwa namara ninda nigifu, ibisigaye nibyiza cyane.

Imbere yo kunanirwa kw'impyiko, abafite amatungo bafite amahitamo make yo guhitamo, mugihe rero bavura cyane, bakuza kandi bakarya siyanse mubushobozi bwabo, biragoye cyane, biragoye cyane cyangwa ntibishoboka rwose kugarura agaciro gasanzwe. Nibyiza kugira azote ya creinine na urea murwego rusanzwe kandi hejuru gato. Numugisha wabo gukira, Niba urangije kugenda, nyiri amatungo azagerageza uko ashoboye. Ubuzima burigihe burigihe. Ahari bazakugarukira vuba, igihe cyose wifuza kwizera.