Lefu la Nephrotic

Nephrotic syndrome ke sehlopha sa matšoao a kenyelletsang liprotheine ka hara moroto, liprotheine tse tlase tsa mali maling, li-cholesterol tse ngata, maemo a phahameng a triglyceride, kotsi e kholo ea mali le ho ruruha.

Nephrotic syndrome e bakoa ke mathata a fapaneng a senyang liphio. Tšenyo ena e lebisa ho lokolloeng ha protheine e ngata haholo morong.

Lebaka le tloaelehileng haholo ho bana ke lefu le fokolang la phetoho. Lembranous glomerulonephritis ke lona sesosa se tloaelehileng ho batho ba baholo. Maloetseng ana ka bobeli, glomeruli e liphio e senyehile. Glomeruli ke meaho e thusang ho sefa litšila le maro.

Boemo bona bo ka hlaha ho tsoa ho:

• Kankere
• Maloetse a kang lefu la tsoekere, systemic lupus erythematosus, myeloma e mengata le amyloidosis
• Mathata a liphatsa tsa lefutso
• Mathata a 'mele
• Matšoao (a kang strep throat, hepatitis, kapa mononucleosis)
• Ts'ebeliso ea lithethefatsi tse itseng

E ka hlaha ka mathata a liphio joalo ka:

• Glomerulosclerosis e shebaneng le karolo
• Glomerulonephritis
• Mesangiocapillary glomerulonephritis

Nephrotic syndrome e ka ama batho ba lilemo tsohle. Ho bana, e atile haholo lipakeng tsa lilemo tse 2 le 6. Boloetse bona bo hlaha hangata hanyane ho banna ho feta basali.

Ho ruruha (edema) ke letšoao le tloaelehileng haholo. E kanna ea etsahala:

• Sefahlehong le haufi le mahlo (ho ruruha ha sefahleho)
• Matsohong le maotong, haholo maotong le maqaqailaneng
• Ka mpeng (mpa e ruruhileng)

Matšoao a mang a kenyelletsa:

• Ho phatloha ha letlalo kapa liso
• Ponahalo e bobebe ya moroto
• Takatso e fosahetseng ea lijo
• Boima ba 'mele (ka boomo) ka ho boloka metsi
• Ho oa

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Liteko tsa laboratori li tla etsoa ho bona hore na liphio li sebetsa hantle hakae. Li kenyeletsa:

• Teko ea mali ea albin
• Liteko tsa chemistry ea mali, joalo ka karolo ea mantlha ea metabolic kapa phanele e phethahetseng ea metabolic
• Naetrojene ea mali ea urea (BUN)
• Creatinine - tlhahlobo ea mali
• Tlhaloso ea Creatinine - teko ea moroto
• Ho hlahloba urinal

Hangata mafura le 'ona a teng morong. Cholesterol ea mali le maemo a triglyceride a ka ba holimo.

Ho ka hlokahala biopsy ea liphio ho fumana sesosa sa lefu lena.

Liteko tsa ho felisa lisosa tse fapaneng li ka kenyelletsa tse latelang:

• Sesole sa mmele sa anti-nuclear
• Li-cryoglobulins
• Tlatsa maemo
• Teko ea mamello ea tsoekere
• Masole a mmele a hepatitis B le C
• Teko ea HIV
• Lebaka la ramatiki
• Serum protheine electrophoresis (SPEP)
• Serology ea syphilis
• Moroto protheine electrophoresis (UPEP)

Lefu lena le ka fetola sephetho sa liteko tse latelang:

• Tekanyo ea vithamine D
• Tšepe ea serum
• Lisebelisoa tsa urinary

Morero oa kalafo ke ho fokotsa matšoao, ho thibela mathata le ho liehisa tšenyo ea liphio. Ho laola nephrotic syndrome, lefu le e bakang le tlameha ho phekoloa. U kanna ua hloka kalafo ea bophelo bohle.

Kalafo e ka kenyelletsa efe kapa efe ea tse latelang:

• Ho boloka khatello ea mali e le tlase ho 130/80 mm Hg ho liehisa tšenyo ea liphio. Angiotensin-converting enzyme (ACE) inhibitors kapa angiotensin receptor blockers (ARBs) ke meriana e sebelisoang khafetsa. ACE inhibitors le li-ARB le tsona li ka thusa ho fokotsa palo ea protheine e lahlehileng morotong.
• Corticosteroids le lithethefatsi tse ling tse hatellang kapa ho khutsisa sesole sa 'mele.
• Ho phekola k'holeseterole e phahameng ho fokotsa kotsi ea mathata a pelo le methapo ea mali - Lijo tse mafura a fokolang, tse nang le k'holeseterole e tlase hangata ha li lekane ho batho ba nang le lefu la nephrotic. Ho ka hlokahala meriana ea ho fokotsa k'holeseterole le triglycerides (hangata li-statin).
• Lijo tse nang le sodium e tlase li ka thusa ho ruruha matsohong le maotong. Lipilisi tsa metsi (diuretics) le tsona li ka thusa ka bothata bona.
• Lijo tse nang le protheine e tlase li ka thusa. Mofani oa hau a ka fana ka maikutlo a lijo tse itekanetseng tsa protheine (1 gram ea protheine ka kilogram ea boima ba 'mele ka letsatsi).
• Ho nka li-supplement tsa vithamine D haeba nephrotic syndrome e nka nako e telele ebile e sa arabele kalafo.
• Ho noa lithethefatsi tse tšesaane mali ho alafa kapa ho thibela ho koaloa hoa mali.

Sephetho sea fapana. Batho ba bang ba hlaphoheloa boemong boo. Ba bang ba ba le lefu la nako e telele la liphio mme ba hloka dialysis mme qetellong ba kenngoe liphio.

Mathata a bophelo bo botle a ka bakoang ke lefu la nephrotic a kenyelletsa:

• Ho hloleha ho matla ha liphio
• Ho thatafala ha methapo le mafu a amanang le pelo
• Lefu le sa foleng la liphio
• Ho tlala mokelikeli, ho hloleha ha pelo, mokelikeli o kenang matšoafong
• Ts'oaetso, ho kenyelletsa le pneumonia ea pneumococcal
• Khaello ea phepo e nepahetseng
• Thapo ea methapo ea pelo

Bitsa mofani oa hau haeba:

• Uena kapa ngoana oa hau le ba le matšoao a lefu la nephrotic, ho kenyelletsa ho ruruha sefahlehong, mpa, kapa matsoho le maoto, kapa liso tsa letlalo.
• Uena kapa ngoana oa hau le phekoloa lefu la nephrotic, empa matšoao ha a ntlafatse
• Ho hlaha matšoao a macha, ho kenyeletsoa ho khohlela, phokotso ea tlhahiso ea moroto, ho se utloise bohloko ka ho ntša metsi, feberu, hlooho e bohloko haholo

E-ea kamoreng ea maemo a tšohanyetso kapa letsetsa nomoro ea lehae ea maemo a tšohanyetso (joalo ka 911) haeba u oa.

Ho sebetsana le maemo a ka bakang nephrotic syndrome ho ka thusa ho thibela lefu lena.

Nephrosis

• Anatomy ea liphio

Lefu la Erkan E. Nephrotic. Ka: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, bahlophisi. Buka ea Nelson ea Pediatrics. La 21 Ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 545.

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.