Mmetụta nephropathy

Membranous nephropathy bụ nsogbu akụrụ nke na-eduga na mgbanwe na mbufụt nke akụkụ dị n'ime akụrụ nke na-enyere nza nzacha na mmiri mmiri. Ọrịa ahụ nwere ike ibute nsogbu na ọrụ akụrụ.

Membranous nephropathy na-ebute site na ndagide nke akụkụ nke membrane okpuru ala. Okpukpo ala okpuru ulo a bu akuku akụrụ nke na enyere aka ihichapụ ihe mkpofu na mmiri ozo n’ime ọbara. Amaghị ihe kpatara kpatara thickening a.

Agba thickmer glomerular anaghị arụ ọrụ ọfụma. N'ihi ya, nnukwu protein na-efu n'ime mmamịrị.

Ọnọdụ a bụ otu n'ime ihe ndị kachasị akpata ọrịa nephrotic. Nke a bụ otu mgbaàmà nke gụnyere protein na mmamịrị, ogo protein dị elu, ogo cholesterol dị elu, nnukwu triglyceride, na ọzịza. Mphranous nephropathy nwere ike ịbụ ọrịa akụrụ bụ isi, ma ọ bụ enwere ike jikọta ya na ọnọdụ ndị ọzọ.

Ihe ndị a na - abawanye n'ihe egwu gị maka ọnọdụ a:

• Ọrịa cancer, ọkachasị akpa ume na eriri afọ
• Ngosipụta na toxins, gụnyere ọla edo na mercury
• Ọrịa, gụnyere ịba ọcha n'anya B, ịba, syphilis, na endocarditis
• Ọgwụ, gụnyere penicillamine, trimethadione, na ude ndị na-enye anụ ọkụ
• Sistem lupus erythematosus sistem, ọrịa ogbu ogbu na nkwonkwo, ọrịa ili, na nsogbu ndị ọzọ autoimmune

Nsogbu a na-eme n'oge ọ bụla, mana ọ na-ahụkarị mgbe afọ 40 gasịrị.

Mgbaàmà na-amalite nwayọ nwayọ oge, ọ nwere ike ịgụnye:

• Edema (ọzịza) n'akụkụ ọ bụla nke ahụ
• Ike ọgwụgwụ
• Amfụfụ mmamịrị nke mmamịrị (n'ihi nnukwu protein)
• Agụụ na-adịghị mma
• Urin, oke n'abalị
• Ibu ibu

Nyocha nke anụ ahụ nwere ike igosi ọzịza (edema).

Otu mmamịrị nwere ike igosi nnukwu protein n’ime mmamịrị ahụ. O nwekwara ike ịbụ na ọbara dị na mamịrị.Ọnụ ọgụgụ filtration glomerular ("ọsọ" nke akụrụ na - ehicha ọbara) na - adịkarị nkịtị.

Enwere ike ime nyocha ndị ọzọ iji hụ ka akụrụ si arụ ọrụ nke ọma yana otu ahụ si anabata nsogbu akụrụ. Ndị a gụnyere:

• Albumin - ọbara na mmamịrị
• Ọbara nitrogen (BUN)
• Creatinine - ọbara
• Nwepu okike
• Ogwe mkpuchi
• Protein - ọbara na mmamịrị

Akụrụ biopsy na-akwado nyocha ahụ.

Ule ndị a nwere ike inyere aka chọpụta ihe kpatara membranous nephropathy:

• Antinuclear-alụso ọrịa ọgụ ule
• Mgbochi DNA nwere okpukpu abụọ, ọ bụrụ na nnwale nke nje ahụ na-egbochi ya
• Nyocha ọbara iji chọpụta ịba ọcha n'anya B, ịba ọcha n'anya C, na syphilis
• Mgbakwunye ọkwa
• Nnwale Cryoglobulin

Ebumnuche nke ọgwụgwọ bụ iji belata mgbaàmà ma belata ọganihu nke ọrịa ahụ.

Rollingchịkwa ọbara mgbali bụ ụzọ kachasị mkpa iji gbochie mmebi akụrụ. Ebumnuche bụ idebe ọbara mgbali na ma ọ bụ n'okpuru 130/80 mm Hg.

A kwesịrị ịgwọ oke cholesterol na triglyceride iji belata ihe egwu nke atherosclerosis. Agbanyeghị, nri abụba dị ala, obere kọlestrọl anaghị adịkarị mkpa maka ndị nwere ọrịa nephropathy.

Ọgwụ eji agwọ membranous nephropathy gụnyere:

• Angiotensin-converting enzyme (ACE) inhibitors na angiotensin ihe nnabata ihe mgbochi (ARBs) iji belata ọbara mgbali
• Corticosteroids na ọgwụ ndị ọzọ na-egbochi usoro mgbochi
• Ọgwụ (ọtụtụ mgbe statins) iji belata cholesterol na triglyceride etoju
• Mkpụrụ ọgwụ mmiri (diuretics) iji belata ọzịza
• Ndị na-eme ka ọbara belata iji belata ọbara maka ngụgụ ọbara na ngụgụ na ụkwụ

Usoro nri nwere obere protein nwere ike inye aka. A pụrụ ịtụ aro iri nri na-adịchaghị edozi ahụ (gram gram 1 kwa kilogram n'arọ kwa ụbọchị).

Enwere ike dochie Vitamin D ma ọ bụrụ na ọrịa nephrotic dị ogologo oge (adịghị ala ala) ma ọ zaghị ọgwụgwọ.

Ọrịa a na-eme ka ohere nke mkpụkọ ọbara na ngụgụ na ụkwụ na-abawanye. Enwere ike idepụta ihe ndị na-edozi ọbara iji gbochie nsogbu ndị a.

Echiche dị iche iche, dabere na oke ọnwụ protein. Enwere ike ịnwe oge anaghị enwe mgbaàmà yana iwe ọkụ mgbe ụfọdụ. Mgbe ụfọdụ, ọnọdụ na-aga, ma ọ bụ na-enweghị ọgwụgwọ.

Imirikiti ndị mmadụ na-arịa ọrịa a ga-enwe mmebi akụrụ na ụfọdụ ndị ga-azụlite ọrịa akụrụ njedebe.

Nsogbu ndị nwere ike ibute ọrịa a gụnyere:

• Adịghị ala ala gbasara akụrụ
• Mkpụrụ obi miri emi nke thrombosis
• Ọgwụgwụ azụ gbasara akụrụ
• Ọrịa Nephrotic
• Ọrịa akpa ume
• Gbasara akwara thrombosis

Kpọọ maka oge nlekọta gị na onye nlekọta ahụike gị ma ọ bụrụ:

• Nwere ihe mgbaàmà nke membranous nephropathy
• Ihe mgbaàmà gị na-akawanye njọ ma ọ bụ ghara ịla
• Develop na-emepe mgbaàmà ọhụụ
• Decre belatala mmamịrị gị

Ngwọta nsogbu ngwa ngwa na izere ihe ndị nwere ike ibute memphran nephropathy nwere ike belata ihe egwu gị.

Membranous glomerulonephritis; Membranous GN; Extramembranous glomerulonephritis; Glomerulonephritis - membranous; MGN

• Akụrụ anatomi

Radhakrishnan J, Appel GB. Nsogbu nke Glomerular na syndromes nephrotic. Na: Goldman L, Schafer AI, eds. Ọgwụ Goldman-Cecil. Nke 26th. Philadelphia, PA: Elsevier; 2020: isi 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Ọrịa glomerular bụ isi. Na: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner na Rector nke akụrụ. Nke 11. Philadelphia, PA: Elsevier; 2020: isi 31.

Salant DJ, Cattran DC. Mmetụta nephropathy. Na: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. Nke isii. Philadelphia, PA: Elsevier; 2019: isi 20.