Kutarisirwa Kwakakosha Kwevarwere Vane Matambudziko Eitsvo
Chirwere cheitsvo chirwere chinodzikira mashandiro eitsvo, zvichiita kuti zviomere muviri kusefa tsvina, kudzora kuenzana kwemvura neelectrolyte, uye kudzora BP. Nekuti itsvo dzinoita basa rakakosha mumiviri yakawanda, kudzikira kwebasa reitsvo kunogona kuva nemigumisiro yakakura - kubva kuzvimba neBP kusvika kuzvirwere zvemapfupa uye kupererwa neropa kusvika kumatambudziko emwoyo. Nokudaro, varwere vane chirwere cheitsvo vanoda kutarisirwa kwakanyatsorongwa, kwakarongwa, uye kwakarongeka kunosanganisira kushanda pamwe chete pakati pemurwere, mhuri, nenyanzvi dzehutano.
Kunzwisisa mhando dzezvirwere zveitsvo
Kazhinji, matambudziko eitsvo anogona kukamurwa kuita mapoka maviri makuru: kukuvara kweitsvo zvakanyanya uye chirwere cheitsvo chisingaperi (CKD). Kukuvara kweitsvo zvakanyanya kunoitika kamwe kamwe, semuenzaniso nekuda kwekushaya mvura mumuviri zvakanyanya, hutachiona, kuvhunduka, kuvharika kwenzira yeweti, kana migumisiro yemimwe mishonga. Dambudziko iri rinogona kuvandudzika kana chikonzero chacho chikarapwa nekukurumidza. Panguva imwecheteyo, chirwere cheitsvo chisingaperi chinokura zvishoma nezvishoma nekufamba kwenguva, kazhinji nekuda kwechirwere cheshuga, BP, kuzvimba kweitsvo, kana kusagadzikana kwekuzvarwa nako. MuCKD, mashandiro eitsvo anodzikira zvishoma nezvishoma uye anogona kufambira mberi kusvika pakutadza kweitsvo kusvika padanho rekupedzisira.
Kunzwisisa rudzi uye nhanho yechirwere cheitsvo kwakakosha nekuti kunosarudza chinangwa chekurapa, zvinangwa zvekurapa, mitemo yekudya, uye nguva yekutarisa chirwere.
Chinangwa chikuru chekurapa varwere vane matambudziko eitsvo
Kutarisirwa kwakakosha kwevarwere vane matambudziko eitsvo kunowanzo kuve nezvinangwa zvikuru. Chekutanga, kuderedza kudzikira kwekushanda kweitsvo uye kudzivirira kukuvara kwakawanda. Chechipiri, kugadzirisa zviratidzo uye kuchengetedza hupenyu hwemurwere—semuenzaniso, kugadzirisa kuda kurutsa, kushaya simba, kuzvimba, uye matambudziko ekurara. Chechitatu, kudzivirira matambudziko akadai seBP isingadzoreki, anemia, matambudziko emapfupa, kuungana kwemvura mumapapu, uye kunyange chirwere chemwoyo. Chechina, kana chirwere chasvika padanho repamusoro, kugadzirira kurapwa kweitsvo senge dialysis kana kuisirwa chimwe chinhu.
Mutemo wezvekudya: chinhu chakakosha pakutarisira
Imwe yenzira dzakakosha dzekurapa ndeyekugadzirisa zvekudya. Zvisinei, kudya kwevarwere vane chirwere cheitsvo hakuna kufanana kune wese munhu. Kugadzirisa zvekudya kunofanirwa kuenderana nedanho rechirwere, mhedzisiro yebvunzo dzemurabhoritari, mamiriro emurwere, uye kana murwere ari kucheneswa nedialysis.
1. Kurambidzwa kwemunyu (sodium)
Sodium yakawandisa inogona kuwedzera BP uye kukonzera kuchengetwa kwemvura mumuviri. Varwere vanokurudzirwa kuderedza kudya kwavo chikafu chine munyu chakadai sechikafu chakagadziriswa, machipisi, manoodles ekukurumidza, masoseji, nuggets, uye zvinonhuhwirira zvine sodium yakawanda. Kuderedza munyu kunobatsira kudzora kuzvimba uye BP.
2. Kudzora kudya mapuroteni
Mune vamwe varwere veCKD vasati vatanga dialysis, mapuroteni anowanzo rambidzwa kuderedza basa reitsvo. Zvisinei, kune varwere vedialysis, zvinodiwa zvemapuroteni zvinogona kuwedzera nekuda kwekurasikirwa nemapuroteni panguva yekuvhiyiwa. Mapuroteni anokurudzirwa kazhinji mapuroteni emhando yepamusoro akadai semazai, hove, huku isina ganda, uye nyama isina mafuta akawanda—muzvikamu zvinokurudzirwa nachiremba kana nyanzvi yezvekudya.
3. Dzora potassium (potassium)
Itsvo dzisina simba dzinonetseka nekuburitsa potassium. Potassium yakawanda inogona kukonzera matambudziko ane njodzi pamoyo. Varwere vanofanira kungwarira zvekudya zvine potassium yakawanda zvakaita semabhanana, avocado, maranjisi, madomasi, mbatatisi, nemvura yekokonati, kunyanya kana mhedzisiro yeropa ichiratidza potassium yakakwira.
4. Kurambidzwa kwePhosphorus
Kuwanda kwephosphorus kunogona kukonzera kuvaviwa, matambudziko emapfupa, uye calcium mutsinga dzeropa. Phosphorus inowanikwa yakawanda mumukaka nezvigadzirwa zvemukaka, nyama dzenhengo, nzungu, uye zvimwe zvekudya nezvinwiwa zvakaputirwa. Vanachiremba vanogona kunyora zvinhu zvinosunga phosphate kana zvichidikanwa.
5. Kudzora mvura
Kana itsvo dzikasakwanisa kuburitsa mvura zvakanaka, varwere vanogona kuzvimba, kufema zvisina kunaka, uye kutowedzera BP. Kudzora mvura kunowanzodiwa, kunyanya kune varwere vane weti shoma kana vari pa dialysis. Mvura haifanirwe kungobva mumvura yekunwa chete asiwo mumasobho, muto, ice cream, nemichero ine muto.
Kutevedzera mitemo yemishonga uye kudzivirira mimwe mishonga
Varwere vane matambudziko eitsvo vanowanzoda mishonga yekudzora BP, chirwere cheshuga, cholesterol, anemia, uye mineral balance. Kutevedzera purogiramu yemishonga kwakakosha. Uyezve, mimwe mishonga inofanira kudzivirirwa kana kutariswa zvakanyanya nekuda kwenjodzi yekushanda kweitsvo kushata, senge mishonga isingashandisi masteroidal anti-inflammatory (NSAIDs) senge ibuprofen nemimwe mishonga inoderedza marwadzo kana ikashandiswa isina kutarisirwa.
Varwere vanofanirawo kungwarira nezvemishonga yemiti, mishonga yekuwedzera, kana mishonga isina kujeka kuti itsvo dzakachengeteka sei. Mishonga yakawanda ine zvinhu zvinogona kukonzera chepfu kana kuti zvine simbi dzinorema. Nheyo yekuchengetedza: bvunza chiremba usati watora chero chinhu usina mushonga.
Kuongorora nguva dzose uye kuongororwa kwerabhoritari
Kutarisirwa kwakakosha kunoda kuongororwa nguva nenguva. Miedzo inowanzo sanganisira creatinine, glomerular filtration rate (eGFR), urea, electrolytes (sodium, potassium), phosphorus, calcium, uye hemoglobin levels, pamwe nekuongororwa kweprotein weti. Kune varwere vane chirwere cheshuga neBP, kuongororwa kweshuga yeropa neBP zuva nezuva kunokurudzirwawo zvikuru.
Kuongororwa nguva dzose kunobatsira vanachiremba kugadzirisa kurapwa uye kuona matambudziko nekukurumidza. Varwere vazhinji vanonzwa "vakanaka" pakutanga kwekushanda kweitsvo kuchiderera, asi kukuvara kunogona kuramba kuchienderera mberi chinyararire. Saka, kuongororwa nguva dzose chikamu chakakosha chekutarisira chisingafanirwe kuregeredzwa.
Kutarisira BP uye shuga yeropa
Kurwara neBP uye chirwere cheshuga ndizvo zvinonyanya kukonzera chirwere cheitsvo chisingaperi. Kudzora zvese izvi ndiko kunobatsira kuderedza kufambira mberi kwekukuvara kweitsvo.
– Kugara kwenguva refu kweropa kunobatsira kuchengetedza tsinga dzeropa dzeitsvo. Kudya zvisina munyu wakawanda, kurovedza muviri kwakakodzera, kuchengetedza huremu hwakanaka, uye kutora mishonga nguva dzose zvese zvinobatsira.
– Shuga yeropa inodzorwa inoderedza kukuvara kwetsinga diki dzeropa dziri muitsvo. Varwere vane chirwere cheshuga vanofanira kurangwa nekudya kwavo, mishonga/insulin, uye kugara vachiongororwa HbA1c sezvinokurudzirwa nevanopa hutano hwavo.
Kurovedza muviri uye mararamiro
Kuita maekisesaizi emuviri kuri nyore kusvika kune pakati nepakati sekufamba netsoka, kuchovha bhasikoro usingamire, kana kurovedza muviri kuri nyore kunogona kuvandudza kugwinya kwemuviri, kubatsira kudzora BP, uye kuvandudza mafungiro. Zvisinei, kugwinya kwacho kunofanira kuenderana nemamiriro emurwere. Varwere vaneta nyore kana kuti vane ropa shoma vangada chirongwa chekurovedza muviri zvishoma nezvishoma.
Zvimwe zvinhu zvakakosha pakurarama zvinosanganisira kurega kusvuta, kuderedza doro, kurara zvakakwana, uye kudzora kushushikana. Kusvuta kunokurumidza kukuvara kwetsinga dzeropa uye kunowedzera njodzi yechirwere chemwoyo, dambudziko guru kune varwere vane chirwere cheitsvo.
Kutarisirwa kwepamusoro: dialysis uye kugadzirira kuiswa kwemushonga wekubvisa kenza
Mukutadza kweitsvo kwakanyanya, mushonga wekutsiva itsvo unodiwa kuti urarame. Sarudzo mbiri huru ndedze hemodialysis ne peritoneal dialysis. Hemodialysis inowanzoitwa munzvimbo yehutano kakawanda pasvondo, nepo peritoneal dialysis inogona kuitwa kumba nekudzidziswa kwakakosha. Imwe neimwe ine zvakanakira zvakasiyana, matambudziko, uye zvinodiwa pakutarisirwa.
Pamusoro pezvo, kuisirwa itsvo kungave ndiyo nzira yakanakisisa kune vamwe varwere, zvichigona kupa hupenyu hwakanaka. Zvisinei, maitiro acho anoda kuongororwa kwakasimba, kugadzirira muviri nepfungwa, uye rutsigiro rwemhuri.
Basa rekutsigira mhuri uye magariro evanhu
Chirwere cheitsvo chinokanganisa hupenyu hwezuva nezuva: shanduko mukudya, kuongororwa nguva dzose, mukana wekuchenesa tsinga, uye mari yakawanda. Rutsigiro rwemhuri rwakakosha kuti varwere varambe vachitevedzera kudya uye kurapwa. Rutsigiro rwepfungwa rwakakosha zvakaenzana. Varwere vazhinji vanonzwa kuzvidya mwoyo, kusuruvara, kana kunzwa kwekuremerwa. Kupa mazano, nzvimbo dzevarwere veitsvo, kana rutsigiro rwepfungwa zvinogona kubatsira varwere kugadzirisa uye kuramba vachikurudzirwa.
Zviratidzo zvengozi zvekuchenjerera
Varwere nemhuri dzavo vanofanira kuziva zviratidzo zvinoda kurapwa nekukurumidza, zvakaita sekushaya mweya, kuzvimba kunowedzera nekukurumidza, kudzikira kukuru kwemushonga weti, kurwadziwa pachipfuva, kushaya simba zvakanyanya, kurutsa kakawanda, kuvhiringidzika, kana kurova kwemoyo kusina kurongeka. Zviratidzo izvi zvinogona kuratidza kuchengetwa kwemvura mumuviri, kusawirirana kwema electrolyte, kana zvimwe zvinetso zvakakomba.
Penutup
Kutarisirwa kwakakosha kwevarwere vane matambudziko eitsvo hakusi kungo "tora mishonga" chete, asi nzira yakazara inosanganisira kugadzirisa zvekudya, kudzora mvura inoyerera kana zvichidikanwa, kudzora BP neshuga yeropa, kutarisa murabhoritari, kugadzirisa mararamiro, uye rutsigiro rwepfungwa nerwemhuri. Nekutarisirwa kwakakodzera uye kwakaringana, varwere vazhinji vanogona kunonotsa kufambira mberi kwechirwere, kudzivirira matambudziko, uye kuchengetedza hupenyu hwakanaka. Chinokosha ndechekushanda pamwe chete navanachiremba, vanamukoti, nenyanzvi dzezvekudya, uye kubvunza mibvunzo kana paine chausinganzwisisi.
