Mob raum

Tus mob raum yog cov qeeb raum tsis ua haujlwm sijhawm. Txoj haujlwm tseem ceeb ntawm lub raum yog kom tshem cov khib nyiab thiab cov dej ntau tshaj hauv lub cev.

Tus mob raum (CKD) maj mam mob heev zuj zus nyob rau lub hli lossis xyoo. Koj yuav tsis pom tsos mob rau qee lub sijhawm. Kev poob haujlwm ntawm lub luag haujlwm yuav ua rau qeeb qeeb uas koj tsis muaj tsos mob kom txog thaum koj lub raum yuav luag tsis ua haujlwm.

Cov theem kawg ntawm CKD yog hu ua cov mob raum ntu kawg (ESRD). Nyob rau theem no, lub raum tsis tuaj yeem tshem tawm cov khib nyiab kom txaus thiab haus dej ntau ntawm lub cev. Txij ntawm no, koj yuav tsum raug lim ntshav los yog lub raum hloov ntshav.

Ntshav qab zib thiab ntshav siab yog qhov 2 ua rau thiab cuam tshuam rau feem ntau.

Ntau lwm yam kab mob thiab xwm txheej tuaj yeem ua rau lub raum puas, suav nrog:

• Cov kab mob autoimmune mob (xws li cov kab mob lupus erythematosus thiab scleroderma)
• Kev yug los ntawm lub raum (xws li mob polycystic raum)
• Qee cov tshuaj lom neeg
• Kev raug mob rau lub raum
• Raum raum thiab kab mob
• Teeb meem nrog cov hlab ntsha pub mis rau lub raum
• Qee yam tshuaj, xws li mob thiab tshuaj mob qog noj ntshav
• Tso zis rov qab rau cov zis mus rau lub raum (reflux nephropathy)

CKD ua rau kev tsim cov kua thiab cov khoom pov tseg hauv lub cev. Tus mob no cuam tshuam rau feem ntau lub cev ua haujlwm thiab ua haujlwm, suav nrog:

• Ntshav siab
• Cov qe ntshav qis tsawg
• Vitamin D thiab pob txha noj qab haus huv

Cov tsos mob thaum ntxov ntawm CKD yog tib yam li rau ntau lwm yam mob. Cov tsos mob no tsuas yog pom lub cim ntawm cov teeb meem thaum ntxov.

Cov tsos mob tuaj yeem suav nrog:

• Qab los noj mov poob
• General mob siab thiab nkees
• Mob taub Hau
• Khaus (pruritus) thiab daim tawv nqaij qhuav
• Xeev siab
• Lub cev yuag yam tsis ua kom yuag

Cov tsos mob uas tuaj yeem tshwm sim thaum lub raum ua haujlwm tau dhau los ua tsis zoo:

• Txawv lub ntsej muag tsaus nti lossis lub teeb tawv nqaij
• Mob pob txha
• Kev nkees nkees lossis teeb meem tsom lossis xav
• Tsa lossis o ntawm tes thiab taw
• Mob leeg ntswj lossis mob plab
• Ua pa tsw ntxhiab tsw
• Ua kom doog ntshav yooj yim, lossis ntshav hauv cov quav
• Kev nqhis dej ntau dhau
• Nquag ntsos
• Cov teeb meem nrog kev sib deev
• Kev coj khaub ncaws nres (mob caj dab)
• Ua tsis taus pa
• Teeb meem pw tsaug zog
• Ntuav

Yuav luag txhua tus neeg yuav muaj ntshav siab rau txhua theem ntawm CKD. Thaum lub sijhawm kuaj mob, koj tus kws kho mob yuav tuaj yeem hnov ​​lub suab txawv txav hauv lub plawv lossis lub ntsws. Koj yuav muaj cov tsos mob ntawm lub paj hlwb thaum lub sij hawm soj ntsuam cov leeg hlwb.

Qhov mob txeeb zig yuav qhia tias muaj protein lossis lwm yam kev hloov pauv hauv koj cov zis. Cov kev hloov no tuaj yeem tshwm sim li 6 txog 10 hlis lossis ntau dua ua ntej cov tsos mob tshwm sim.

Kev ntsuam xyuas uas tshawb xyuas seb ob lub raum ua haujlwm tau zoo npaum li cas:

• Creatinine kev tshem tawm
• Qib Creatinine qib
• Ntshav urea nitrogen (BUN)

CKD pauv qhov tshwm sim ntawm ntau lwm cov ntawv xeem. Koj yuav tsum tau kuaj nram qab no ntau npaum li cas txhua txhua 2 rau 3 hlis thaum mob raum muaj mob ntau dua:

• Albumin
• Tshuaj calcium
• Cov roj khov ua tiav
• Ua kom tiav cov ntshav suav (CBC)
• Kev Txuas Hluav Taws Xob
• Hlau nplaum
• Phosphorous
• Qab Zib
• Kev Sodium

Lwm txoj kev kuaj mob uas tuaj yeem kuaj xyuas seb yog vim li cas lossis hom mob raum muaj xws li:

• CT scan ntawm lub plab mog
• MRI ntawm lub plab mog
• Ultrasound ntawm plab
• Raum raum
• Lub raum scan
• Lub raum ultrasound

Tus kab mob no kuj tseem tuaj yeem pauv cov txiaj ntsig ntawm kev sim hauv qab no:

• Erythropoietin
• Parathyroid hormone (PTH)
• Kev ntsuam xyuas cov pob txha ceev
• Qib Vitamin D

Tswj ntshav siab yuav ua rau lub raum puas txuas ntxiv.

• Angiotensin-converting enzyme (ACE) inhibitors lossis angiotensin receptor blockers (ARBs) yog siv ntau zaus.
• Lub hom phiaj yog txhawm rau ua kom cov ntshav siab lossis qis dua 130/80 hli Hg.

Hloov kev ua neej nyob tuaj yeem pab tiv thaiv ob lub raum, thiab tiv thaiv kab mob plawv thiab mob stroke, xws li:

• TSIS TXHOB haus luam yeeb.
• Noj cov zaub mov uas muaj roj tsawg thiab cov roj cholesterol.
• Ua kev tawm dag zog tas li (tham nrog koj tus kws kho mob lossis tus neeg saib xyuas neeg mob ua ntej pib qoj ib ce).
• Noj tshuaj txo qis koj cov roj cholesterol, yog tias xav tau.
• Tswj koj cov ntshav qab zib kom tsawg.
• Tsis txhob noj ntsev ntau dhau los ntxiv.

Nco ntsoov tham nrog koj tus kws kho mob raum ua ntej noj cov tshuaj yuav tom kiab khw. Qhov no suav nrog cov vitamins, tshuaj ntsuab thiab tshuaj ntxiv. Nco ntsoov tias txhua tus kws khomob koj tuaj ntsib koj paub tias koj muaj CKD. Lwm yam kev kho mob suav nrog:

• Cov tshuaj hu ua phosphate binders, los pab tiv thaiv kom muaj theem phosphorous
• Cov hlau tshwj xeeb ntxiv rau hauv kev noj haus, tshuaj noj hlau, hlau muab los ntawm cov leeg ntshav (cov leeg hlau) tshwj xeeb txhaj tshuaj hu ua erythropoietin, thiab ntshav ntxiv los kho ntshav
• Ntxiv calcium thiab vitamin D (ib txwm nrog koj tus kws kho mob tham ua ntej noj)

Koj tus kws khomob yuav kom koj ua raws li kev noj haus tshwj xeeb rau CKD.

• Txwv kev haus dej ntau
• Noj cov protein tsawg
• Txwv kev phosphorous thiab lwm yam electrolytes
• Tau txais cov calories kom txaus los tiv thaiv kev poob phaus

Txhua tus neeg uas nrog CKD yuav tsum hloov txog kev txhaj tshuaj tiv thaiv txuas ntxiv no:

• Tshuaj tiv thaiv kab mob siab hom A
• Tshuaj tiv thaiv kab mob siab B
• Tshuaj tiv thaiv khaub thuas
• Tshuaj tiv thaiv mob ntsws (PPV)

Qee cov neeg tau txais txiaj ntsig los ntawm kev koom tes hauv pab pawg kab mob raum.

Coob leej tsis tau paub tus mob CKD kom txog rau thaum lawv poob ntawm lawv lub raum feem ntau.

Yog tsis muaj kev kho rau CKD. Yog tias nws cuam tshuam rau ESRD, thiab sai npaum li cas, nyob ntawm:

• Qhov ua rau lub raum puas
• Zoo li cas koj tu koj tus kheej

Mob raum tsis ua haujlwm yog theem kawg ntawm CKD. Nov yog thaum koj ob lub raum tsis tuaj yeem pab txhawb peb lub cev cov kev xav tau.

Koj tus kws kho mob yuav nrog koj tham txog kev lim ntshav ua ntej koj xav tau. Kev lim ntshav tshem tawm cov khib nyiab hauv koj cov ntshav thaum koj ob lub raum tsis tuaj yeem ua haujlwm ntxiv.

Feem ntau, koj yuav mus rau kev lim ntshav thaum koj tsuas muaj 10 txog 15% ntawm koj lub raum ua haujlwm sab laug.

Txawm hais tias cov neeg uas tab tom tos raum hloov raum yuav tsum tau lim ntshav thaum tos.

Teeb meem yuav suav nrog:

• Mob Kev Plab
• Los ntshav los ntawm lub plab lossis cov hnyuv
• Mob pob txha, mob pob txha, thiab mob leeg
• Hloov ntshav qab zib
• Kev puas tsuaj rau cov leeg ntawm ob txhais ceg thiab caj npab (mob raum)
• Kev nyuaj siab
• Cov kua dej ua kom lub ntsws nyob ib puag ncig lub ntsws (pleural effusion)
• Lub plawv thiab cov hlab ntsha muaj teeb meem
• Muaj phosphorous theem
• Muaj cov poov tshuaj ntau ntau
• Hyperparathyroidism
• Nce muaj feem yuav kis tau
• Lub siab ua haujlwm puas lossis ua haujlwm poob
• Khoom noj khoom haus tsis muaj zog
• Lwm yam thiab ntxiv lawm tshob
• Qaug dab peg
• O o (edema)
• Kev tsis muaj zog ntawm cov pob txha thiab nce kev pheej hmoo ntawm kev tawg taus

Kho cov mob uas ua rau qhov teeb meem tuaj yeem pab tiv thaiv lossis qeeb CKD. Cov neeg uas muaj ntshav qab zib yuav tsum tswj lawv cov ntshav qab zib thiab ntshav siab thiab yuav tsum tsis txhob haus luam yeeb.

Raum tsis ua haujlwm - mob ntev; Mob raum tsis ua haujlwm - mob ntev; Mob raum tsis txaus; Mob raum tsis ua haujlwm; Mob raum tsis ua hauj lwm

• Raum anatomy
• Raum - ntshav thiab zis txaus
• Glomerulus thiab nephron

Christov M, Sprague SM. Mob raum - mob pob txha pob txha. Hauv: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner thiab Rector's Raum. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 53.

Grams ME, McDonald SP. Epidemiology ntawm kev mob raum tsis ntev thiab kev lim ntshav. Hauv: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Cov Chaw Kho Mob Tshaj Loj. 6 tus ed. Philadelphia, PA: Elsevier; 2019: chap 77.

Taal MW. Kev faib tawm thiab tswj hwm tus mob raum. Hauv: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner thiab Rector's Raum. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 59.