Prerenal azotemia

Prerenal azotemia ke sehlahisoa se phahameng ka mokhoa o sa tloaelehang oa litšila tsa naetrojene maling.

Prerenal azotemia e tloaelehile, haholo-holo ho batho ba baholo le ho batho ba sepetlele.

Liphio li sefa mali. Li boetse li etsa moroto ho tlosa litšila. Ha palo, kapa khatello, ea mali e phalla ka marotholi a liphio, ho sefa mali le hona ho theoha. Kapa e kanna ea se ke ea etsahala ho hang. Lihlahisoa tsa litšila li lula maling. Ho etsoa moroto o monyane kapa o se nang oona, leha phiyo ka boeona e ntse e sebetsa.

Ha lihlahisoa tsa naetrojene, joalo ka creatinine le urea, li eketseha 'meleng, boemo boo bo bitsoa azotemia. Litšila tsena li sebetsa joaloka chefo ha li aha. Li senya lisele le ho fokotsa bokhoni ba litho tsa ho sebetsa.

Prerenal azotemia ke mokhoa o atileng haholo oa ho hloleha ha liphio bathong ba lipetlele. Boemo bofe kapa bofe bo fokotsang phallo ea mali ho ea liphio bo ka e baka, ho kenyelletsa:

• Chesa
• Maemo a lumellang mokelikeli ho tsoa maling
• Ho hlatsa ha nako e telele, letshollo, kapa ho tsoa mali
• Ho hlahisa mocheso
• Ho fokotseha ha mokelikeli (ho felloa ke metsi)
• Ho lahleheloa ke molumo oa mali
• Meriana e meng, e kang ACE inhibitors (lithethefatsi tse phekolang ho hloleha ha pelo kapa khatello e phahameng ea mali) le li-NSAID

Maemo ao ho 'ona pelo e sa khoneng ho pompa mali a lekaneng kapa a pompa mali ka molumo o tlase le ona o eketsa kotsi ea prerenal azotemia. Maemo ana a kenyelletsa:

• Ho hloleha ha pelo
• Ho tsosoa (ts'oaetso ea septic)

E ka boela ea bakoa ke maemo a sitisang phallo ea mali ho ea liphio, joalo ka:

• Mefuta e meng ea ho buuoa
• Ho lematsa liphio
• Ho thijoa ha mothapo o fanang ka mali ho liphio (ho koaloa ha methapo ea pelo)

Prerenal azotemia e kanna ea se be le matšoao. Kapa, ​​matšoao a lisosa tsa prerenal azotemia a ka ba teng.

Matšoao a ho felloa ke metsi 'meleng a ka ba teng' me a kenyelletsa tse ling tsa tse latelang:

• Pherekano
• Ho fokotseha kapa ha ho na tlhahiso ea moroto
• Molomo o omileng ka lebaka la lenyora
• Ho otla ka potlako
• Mokhathala
• 'Mala oa letlalo o phatsimang
• Ho ruruha

Tlhahlobo e ka bontša:

• Methapo ea molala e robehileng
• Lera le omileng
• Moroto o monyane kapa o se nang letho ka senya
• Khatello ea mali e tlase
• Ts'ebetso e tlase ea pelo kapa hypovolemia
• Ho saroloha ha letlalo hampe (turgor)
• Ho otla ha pelo ka potlako
• Khatello ea khatello ea pelo e fokotsehileng
• Matšoao a ho hloleha ha liphio a hlobaetsang

Liteko tse latelang li ka etsoa:

• Creatinine ea mali
• BUN
• Motsoako oa moroto le matla a khoheli a itseng
• Liteko tsa moroto ho lekola maemo a sodium le creatinine le ho lekola ts'ebetso ea liphio

Morero oa mantlha oa kalafo ke ho lokisa sesosa kapele pele liphio li senyeha. Hangata batho ba hloka ho lula sepetlele.

Maro a kenang ka har'a methapo (IV), ho kenyelletsa mali kapa lihlahisoa tsa mali, a ka sebelisoa ho eketsa molumo oa mali. Kamora hore molumo oa mali o khutlisoe, meriana e ka sebelisoa ho:

• Eketsa khatello ea mali
• Ntlafatsa ho pompa ha pelo

Haeba motho a e-na le matšoao a ho hloleha ha liphio haholo, kalafo e kanna ea kenyelletsa:

• Dialysis
• Liphetoho tsa lijo
• Meriana

Prerenal azotemia e ka fetoloa haeba sesosa se ka fumanoa le ho lokisoa nakong ea lihora tse 24. Haeba sesosa se sa lokisoe kapele, tšenyo e ka hlaha liphio (acute tubular necrosis).

Mathata a ka kenyelletsa:

• Ho hloleha ho matla ha liphio
• Acute tubular necrosis (lefu la lisele)

E-ea kamoreng ea maemo a tšohanyetso kapa u letsetse nomoro ea ts'ohanyetso ea lehae (joalo ka 911) haeba u na le matšoao a prerenal azotemia.

Ho phekola ka potlako boemo bofe kapa bofe bo fokotsang bophahamo kapa matla a phallo ea mali ka liphio ho ka thusa ho thibela prerenal azotemia.

Azotemia - prerenal; Uremia; Ho se sebetse hantle ha renal; Ho hloleha ho matla ha renal - prerenal azotemia

• Anatomy ea liphio
• Liphio - phallo ea mali le moroto

Haseley L, Jefferson JA. Pathophysiology le etiology ea kotsi e mpe ea liphio. Ho: Feehally J, Floege J, Tonelli M, Johnson RJ, bangoli. Kakaretso ea Nephrology ea Kliniki. La 6th. Philadelphia, PA: Elsevier; 2019: khaolo ea 66.

Okusa MD, Portilla D. Pathophysiology ea kotsi e mpe ea liphio. 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 28.

Wolfson AB. Ho hloleha ha renal. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 87.