Khopolo-taba ea nephropathy

Membranous nephropathy ke lefu la liphio le lebisang liphetohong le ho ruruha ha meaho e kahare ea liphio e thusang ho sefa litšila le maro. Ho ruruha ho ka baka mathata ka tšebetso ea liphio.

Membranous nephropathy e bakoa ke ho tenya ha karolo e 'ngoe ea lera le ka tlase le benyang. Lera le kamoreng e ka tlase ea glomerular ke karolo ea liphio tse thusang ho sefa litšila le mokelikeli o mong o tsoang maling. Lebaka le tobileng la ho tenya hona ha le tsejoe.

Lera le koahetsoeng la glomerular ha le sebetse ka mokhoa o tloaelehileng. Ka lebaka leo, liprotheine tse ngata li lahlehile ka har'a moroto.

Boemo bona ke e 'ngoe ea lisosa tse atileng haholo tsa lefu la nephrotic. Sena ke sehlopha sa matšoao a kenyeletsang protheine ka morong, liprotheine tse tlase tsa mali, maemo a phahameng a k'holeseterole, maemo a phahameng a triglyceride le ho ruruha. Membranous nephropathy e ka ba lefu le ka sehloohong la liphio, kapa e ka amahanngoa le maemo a mang.

Lintho tse latelang li eketsa kotsi ea boemo bona:

• Kankere, haholo-holo mofetše oa matšoafo le mala
• Ho hlahisa chefo, ho kenyelletsa khauta le mercury
• Ts'oaetso, ho kenyelletsa hepatitis B, malaria, syphilis le endocarditis
• Meriana, ho kenyelletsa penicillamine, trimethadione le litlolo tse bonesang letlalo
• Systemic lupus erythematosus, ramatiki ea ramatiki, lefu la mabitla, le mathata a mang a autoimmune

Boloetse bona bo hlaha ka lilemo tsohle, empa bo atile haholo kamora lilemo tse 40.

Matšoao a atisa ho qala butle ha nako e ntse e feta, 'me a ka kenyelletsa:

• Edema (ho ruruha) sebakeng sefe kapa sefe sa 'mele
• Mokhathala
• Ponahalo ea foam ea moroto (ka lebaka la liprotheine tse ngata)
• Takatso e fosahetseng ea lijo
• Ho rota, bosiu haholo
• Boima ba 'mele

Tlhahlobo ea 'mele e ka bontša ho ruruha (edema).

Ho hlahlojoa ha metsi ho ka senola palo e kholo ea protheine ka har'a moroto. Ho ka ba le mali maling a moroto.Sekhahla sa karafo ea glomerular ("lebelo" leo liphio li hloekisang mali ka lona) hangata e batla e le se tloaelehileng.

Liteko tse ling li ka etsoa ho bona hore na liphio li sebetsa hantle hakae le hore na 'mele o ikamahanya joang le bothata ba liphio. Tsena li kenyelletsa:

• Albumin - mali le moroto
• Naetrojene ea mali ea urea (BUN)
• Creatinine - mali
• Tlhaloso ea Creatinine
• Karolo ea lipid
• Liprotheine - mali le moroto

Biopsy ea liphio e tiisa ho fumanoa.

Liteko tse latelang li ka thusa ho tseba sesosa sa nephropathy ea lera:

• Teko ea lithibela-mafu tsa likokoana-hloko
• Anti-strand DNA, haeba tlhahlobo ea lithibela-mafu ea anti-nuclear e nepahetse
• Liteko tsa mali ho hlahloba hepatitis B, hepatitis C le syphilis
• Tlatsa maemo
• Teko ea Cryoglobulin

Morero oa kalafo ke ho fokotsa matšoao le ho liehisa kholo ea lefu lena.

Ho laola khatello ea mali ke eona tsela ea bohlokoahali ea ho liehisa tšenyo ea liphio. Morero ke ho boloka khatello ea mali e le tlase kapa ka tlase ho 130/80 mm Hg.

Cholesterol e phahameng ea mali le litekanyetso tsa triglyceride li lokela ho phekoloa ho fokotsa kotsi ea atherosclerosis. Leha ho le joalo, lijo tse nang le mafura a fokolang, tse nang le k'holeseterole e tlase hangata ha li thuse batho ba nang le nephropathy ea lera.

Meriana e sebelisetsoang ho phekola nephropathy ea lisele e kenyelletsa:

• Angiotensin-converting enzyme (ACE) inhibitors le angiotensin receptor blockers (ARBs) ho fokotsa khatello ea mali
• Corticosteroids le lithethefatsi tse ling tse hatellang sesole sa 'mele
• Meriana (hangata li-statin) ho fokotsa maemo a k'holeseterole le triglyceride
• Lipilisi tsa metsi (diuretics) ho fokotsa ho ruruha
• Li-thinner tsa mali ho fokotsa kotsi ea mali a matšoafo le maoto

Lijo tse nang le protheine e tlase li ka thusa. Ho ka hlahisoa lijo tse nang le protheine e itekanetseng (grama e le 'ngoe ea protheine ka kilograma ea lik'hilograma tsa boima ba' mele ka letsatsi).

Vithamine D e kanna ea hloka ho nkeloa sebaka haeba nephrotic syndrome e nka nako e telele (e sa foleng) mme e sa arabele kalafong.

Lefu lena le eketsa kotsi ea ho koaloa ha mali matšoafong le maotong. Ho ka fanoa ka litšila tsa mali ho thibela mathata ana.

Pono e fapana, ho latela bongata ba tahlehelo ea protheine. Ho kanna ha ba le linako tse se nang matšoao le ho phatloha ka linako tse ling. Ka linako tse ling, boemo boa fela, ka kalafo kapa ntle le eona.

Boholo ba batho ba nang le lefu lena ba tla ba le tšenyo ea liphio 'me batho ba bang ba tla ba le lefu la renal.

Mathata a ka hlahisoang ke lefu lena a kenyelletsa:

• Ho hloleha ho sa foleng ha renal
• Thrombosis e tebileng ea venous
• Boloetse ba renal
• Lefu la Nephrotic
• Embolism ea pulmonary
• Thapo ea methapo ea pelo

Bitsa kopano le mofani oa tlhokomelo ea bophelo haeba:

• O na le matšoao a nephropathy ea lera
• Matšoao a hau a mpefala kapa ha a fele
• U hlahisa matšoao a macha
• U fokolitse tlhahiso ea moroto

Ho sebetsana ka potlako le mathata le ho qoba lintho tse ka bakang nephropathy ea lisele ho ka fokotsa kotsi ea hau.

Letsoho glomerulonephritis; Sehopotso sa GN; Glomerulonephritis e feteletseng; Glomerulonephritis - lera; MGN

• Anatomy ea liphio

Radhakrishnan J, Appel GB. Mathata a Glomerular le syndromes ea nephrotic. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Lefu la mantlha la glomerular. Ka: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, li-eds. Brenner le Rector ea Liphio. 11th ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 31.

Salant DJ, Cattran DC. Khopolo-taba e amanang le mohopolo. Ho: Feehally J, Floege J, Tonelli M, Johnson RJ, bangoli. Kakaretso ea Nephrology ea Kliniki. La 6th. Philadelphia, PA: Elsevier; 2019: khaolo ea 20.