Abin baƙin ciki, ciwon sukari galibi yana haifar da rikicewar koda, kuma suna da haɗari sosai. Lalacewa ga ƙodan tare da ciwon sukari yana ba wa mara lafiya babban matsaloli. Saboda don lura da gazawar koda, dole ne a aiwatar da hanyoyin diyya akai-akai. Idan kun yi sa'a ku sami mai ba da gudummawa, to, sai su yi aikin ƙwayar koda. Cutar koda a cikin ciwon sukari galibi tana haifar da mutuwa mai raɗaɗi ga marasa lafiya.
Idan ciwon sukari yayi kyau wajen sarrafa sukari na jini, to za'a iya magance rikicewar koda.
Labari mai dadi shine, idan ka kiyaye sukarin jininka kusa da al'ada, hakika zaka iya hana lalacewar koda. Don yin wannan, kuna buƙatar tsunduma cikin lafiyarku.
Hakanan zaku ji daɗin cewa matakan hana cutar koda kuma suna taimakawa don hana sauran rikice-rikice na ciwon sukari.
Yadda cutar siga ke haifar da lalacewar koda
A kowane koda, mutum yana da ɗaruruwan dubunnan da ake kira “glomeruli”. Waɗannan matattara ne waɗanda ke tsarkake jinin sharar gida da gubobi. Jinin yana wucewa cikin matsin lamba ta kananan kananan abubuwa na glomeruli kuma ana tacewa. Yawancin ruwa da sauran abubuwan da suke tare da jini suna komawa jikin mutum. Kuma sharar gida, tare da karamin ruwa, yana wucewa daga kodan zuwa mafitsara. Sannan an cire su a waje ta cikin urethra.
A cikin ciwon sukari, jini tare da yawan sukari mai yawa yana wuce kodan. Glucose yana jawo ruwa mai yawan gaske, wanda ke haifar da karuwar matsin lamba a cikin kowace glomerulus. Sabili da haka, ƙirar fillo na dunƙule - wannan alama ce mai mahimmanci na nuna ingancin kodan - yawancin lokaci yana ƙaruwa a farkon matakan ciwon sukari. Dunkin glomerulus yana zagaye da wata tsoka da ake kira “glomerular basemb membrane”. Kuma wannan membrane ya yi kauri kamar yadda yakamata, kamar sauran kyallen takarda wadanda suke kusa da shi. A sakamakon haka, abubuwan da ke ciki a cikin glomeruli suna ƙaura cikin hankali a hankali. Lessarancin ƙarancin glomeruli ya kasance, mafi muni da kodan suna tace jini. Tunda kodan mutum yana da muhimmiyar ajiyar kayan ƙwayar cuta ta glomeruli, ana cigaba da aikin tsarkake jini.
A ƙarshe, kodan sun yanke jiki sun bayyana alamun cutar gawar koda:
- bari;
- ciwon kai
- amai
- zawo
- fata itching;
- ƙarfe ɗanɗano a bakin;
- mummunan numfashi, tunawa da kamshin fitsari;
- karancin numfashi, koda da karamin kokarin jiki da yanayin kwanciyar hankali;
- cramps da cramps a cikin kafafu, musamman ma maraice, kafin lokacin bacci;
- asarar sani, coma.
Wannan yana faruwa, a matsayin mai mulkin, bayan shekaru 15 na ciwon sukari, idan an kiyaye sukarin jini, ba a kula da cutar sukari. Cutar huhu na faruwa - tarin ɓarin nitrogenous a cikin jini wanda kodan ya shafa ba za su iya sake tacewa ba.
Binciken da kuma nazarin kodan a cikin ciwon sukari
Don bincika kodanku don ciwon sukari, kuna buƙatar yin gwaje-gwaje masu zuwa
- gwajin jini don creatinine;
- nazarin fitsari don albumin ko microalbumin;
- urinalysis don creatinine.
Sanin matakin ƙirar creatinine a cikin jini, zaku iya ƙididdige yawan ƙwayoyin ƙwayoyin cuta na ƙwayoyin cuta na ƙodan. Sun kuma gano idan akwai microalbuminuria ko a'a, kuma ana lissafin rabo na albumin ga creatinine a cikin fitsari. Don ƙarin bayani game da duk waɗannan gwaje-gwajen da alamomin aikin ƙodan, karanta "Wadanne gwaje-gwaje ne zasu shuɗe don tantance ƙodan" (yana buɗewa ta taga daban).
Alamar farkon matsalar matsalolin koda a cikin ciwon suga shine microalbuminuria. Albuminin furotin ne wanda kwayoyin su suke kanana a diamita. Kodan lafiya lafiyayyen ya wuce kadan cikin fitsari. Da zaran aikinsu ya karu sosai, akwai sauran albumin a cikin fitsari.
Manyan alamun dake nuna albuminuria
| Albuminuria da fitsari safe, mcg / min | Albuminuria kowace rana, mg | Cakuda albumin a cikin fitsari, mg / l | Matsakaicin albumin / creatinine fitsari, mg / mol | |
|---|---|---|---|---|
| Normoalbuminuria | < 20 | < 30 | < 20 | <2.5 ga maza da <3.5 ga mata |
| Microalbuminuria | 20-199 | 30-299 | 20-199 | 2.5-25.0 na maza da 3.5-25.0 na mata |
| Macroalbuminuria | >= 200 | >= 300 | >= 200 | > 25 |
Ya kamata ka sani cewa karuwar albumin a cikin fitsari na iya zama ba kawai saboda lalacewar koda ba. Idan jiya akwai gagarumin aiki a jiki, yau albuminuria na iya sama da yadda ya kamata. Dole ne a yi la’akari da hakan yayin tsara ranar bincike. Hakanan ana kara albarkar Albuminuria: rage cin abinci mai gina jiki, zazzabi, cututtukan urinary, cututtukan zuciya, ciki. Rarraba albumin ga creatinine a cikin fitsari wata alama ce da ta fi dogara game da matsalolin koda. Karanta karin bayani game da shi anan (yana buɗewa ta wani taga daban)
Idan an samo haƙuri tare da ciwon sukari sau da yawa tare da microalbuminuria, wannan yana nuna cewa yana da haɓakar haɗarin ba wai kawai gazawar koda ba, har ma da cututtukan zuciya. Idan ba a bi da shi ba, to daga baya karfin tacewa da kodan zai zama da rauni, kuma sauran sunadarai masu girma da yawa suna fitowa a cikin fitsari. Wannan ake kira proteinuria.
Abin da ya fi muni da kodan na aiki, haka ma yake haifar da ƙwayoyin halittar jini a cikin jini. Bayan ƙididdige yawan ƙirar gidan ƙasa, zai yiwu a tantance matakin da mai cutar kansa yake ciki.
Matakan cututtukan koda na koda, ya danganta da ƙimar fillo na duniya
Matakin lalacewar koda | Adadin filter na glomerular (GFR), ml / min / 1.73 m2 |
|---|---|
Al'ada | > 90 |
1 | > 90, tare da gwaje-gwaje da ke nuna alamun matsalolin koda |
2 | 60-90 - raunin ƙananan yara |
3-A | 45-59 - lalacewar koda |
3-B | 30-44 - lalacewar koda |
4 | 15-29 - matsanancin rarar ɗan yara |
5 | <15 ko dialysis - gazawar na koda |
Bayanan kula zuwa teburin. Shaidar matsalolin koda wanda ke nuna gwaji da gwaje-gwaje. Zai iya kasancewa:
- microalbuminuria;
- proteinuria (kasancewar manyan kwayoyin sunadarai a cikin fitsari);
- jini a cikin fitsari (bayan duk sauran dalilan da aka yanke hukunci);
- raunin tsarin, wanda ya nuna raunin kodan;
- glomerulonephritis, wanda kwayar halittar koda ta tabbatar dashi.
A matsayinka na mulkin, alamu sun fara bayyana ne kawai a mataki na 4 na cutar koda. Kuma duk matakan da suka gabata suna ci gaba ba tare da bayyanar abubuwa na waje ba. Idan ya juya don gano matsalolin koda a farkon matakin farko da fara magani akan lokaci, to haɓakar ƙarancin koda galibi ana hana shi. Har yanzu, muna bada shawara mai kyau cewa kuyi gwajin gwajin ku a kai aƙalla sau ɗaya a shekara, kamar yadda aka bayyana a sashen “Abin da gwajin dazaiyi don bincika ƙodan ku. A lokaci guda, zaku iya bincika matakan urea da uric acid a cikin jini.
Nau'in allunan ciwon sukari na 2 wanda aka yarda a yi amfani dashi a matakai daban-daban na cutar koda
| Magunguna | Matakan lalacewar koda, wanda aka ba shi izinin nema |
|---|---|
| Metformin (Siofor, Glucofage) | 1-3a |
| Glibenclamide, gami da micronized (Maninyl) | 1-2 |
| Gliclazide da Gliclazide MV (Glidiab, Actos) | 1-4* |
| Glimepiride (Amaryl) | 1-3* |
| Glycvidone (Glurenorm) | 1-4 |
| Glipizide, gami da tsawaita (Movogleken, Glibens retard) | 1-4 |
| Sake Bayani (NovoNorm, Diagninid) | 1-4 |
| Kateglinide (Starlix) | 1-3* |
| Karenn (Aactos) | 1-4 |
| Sitagliptin (Januvius) | 1-5* |
| Vildagliptin (Galvus) | 1-5* |
| Saxagliptin (Onglisa) | 1-5* |
| Linagliptin (Trazhenta) | 1-5 |
| Exenatide (Baeta) | 1-3 |
| Liraglutid (Victoza) | 1-3 |
| Acarbose (Glucobai) | 1-3 |
| Insulin | 1-5* |
Bayanin kula ga tebur.
* A cikin matakan 4-5 na lalacewar koda, kuna buƙatar daidaita sashi na miyagun ƙwayoyi. Hakanan, yayin da cutar koda ke ci gaba, rushewar insulin a cikin jiki yana raguwa. Wannan yana ƙara haɗarin haɗarin hypoglycemia. Saboda haka, buƙatar insulin allurai yana buƙatar gyarawa zuwa ƙasa.
Marasa lafiya waɗanda ke cikin haɗarin haɓakar koda.
| Rukunin marasa lafiya | Sau nawa ya kamata a duba |
|---|---|
| Nau'in masu cutar sukari na 1 da suka kamu da rashin lafiya tun suna yara ko bayan balaga | Shekaru 5 bayan fara ciwon sukari, sannan a shekara |
| Nau'in masu cutar sukari na 1 da suka kamu da rashin lafiya yayin balaga | Nan da nan idan aka gano cutar, sannan a shekara |
| Nau'in Marasa lafiya na 2 | Nan da nan idan aka gano cutar, sannan a shekara |
| Matan da ke da juna biyu masu ciwon suga ko masu fama da cutar siga | Lokaci 1 a kowane watanni uku |
Yin rigakafin lalacewar koda a cikin cutar sankara
Cutar koda na kullum yana faruwa a cikin kusan 1/3 na marasa lafiya da ke da nau'in 1 da nau'in ciwon sukari na 2, wato, nesa da komai. Da alama zaku iya samun alamun cututtukan gazawar koda ya dogara da sakamakon gwajin da muka bayyana a sashin da ya gabata. Testsauki gwaje-gwaje ku tattauna sakamakonsu tare da likitan ku.
Abin da za ku iya yi don hana lalacewar koda a cikin ciwon sukari:
- kiyaye sukarin jini kusa da al'ada - wannan shine mafi mahimmanci
- bincika labarin "Abincin abinci don kodan da ciwon sukari";
- koyaushe auna karfin jini a gida tare da tonometer (yadda ake yin shi daidai don sakamakon ya zama daidai);
- karfin jininka yakamata ya zama al'ada, kasa da 130/80;
- ɗauki gwaje-gwaje waɗanda ke bincika aikin kodan aƙalla lokaci 1 a shekara;
- yi duk abin da ya wajaba don sarrafa sukari, hawan jini, cholesterol da kitsen jini, gami da shan magunguna wanda likitanka ya umarta;
- manne wa tsarin abincin da ya dace don ciwon sukari (a wannan batun, shawarar “hukuma” sun sha bamban sosai da namu, karanta ƙasa a wannan labarin);
- saka hannu a cikin aikin motsa jiki na yau da kullun, gwada motsa jiki a gida tare da dumbbells mai haske, waɗanda ke da cikakken hadari ga kodan;
- bugu da giya “a alamance,” kada a bugu;
- daina shan sigari;
- Ka nemi likita, wanda zai “jagoranci” ciwon ka, ka tafi zuwa gare shi a kai a kai.
Karatun ya tabbatar da tabbaci cewa shan sigari da kanta muhimmin abu ne wanda ke kara hadarin kamuwa da cutar sikarin koda. Daina shan sigari ba shawarwari ne na yau da kullun ba, amma buƙatar gaggawa ne.
Cutar Ciwon koda
Likita ya wajabta maganin kula da koda don ciwon sukari, ya danganta da matakin cutar su. Babban nauyin sanya alƙawura ya kasance tare da mai haƙuri. Wani abu kuma ya dogara da danginsa.
Mun lissafa manyan wuraren aikin kwantar da hankali don cututtukan koda a cikin ciwon sukari:
- m iko da sukari na jini;
- saukar da karfin jini zuwa matakin manufa na 130/80 mm RT. Art. kuma a kasa;
- kiyaye ingantaccen abinci mai kyau ga matsalolin koda;
- kula da cholesterol da triglycerides (fats) a cikin jini;
- dialysis;
- kamun kafa.
Labarin "Ciwon Mara na Ciwon Mara Lafiya" ya yi bayani game da magance cutar koda a cikin masu ciwon suga. Dubi kuma “Rage abinci don kodan da ciwon sukari.”
Ciwon sukari da kodan: abin da kuke buƙatar tunawa
Idan akwai matsaloli tare da kodan, to gwajin jini na creatinine da fitsari don microalbuminuria na iya gano su da wuri. Idan aka fara jiyya akan lokaci, wannan yana kara yawan damar samun nasara. Sabili da haka, gwajin da aka bayyana anan (yana buɗewa ta wani taga daban) dole ne a gabatar da shi akai-akai sau ɗaya a shekara. Yi la'akari da yin amfani da abinci mai ƙayyadaddun carbohydrate don daidaita sukarin jini. Karanta ƙari a labarin "Abincin abinci don kodan tare da ciwon sukari."
Ga yawancin masu ciwon sukari da ke da cutar hawan jini, ban da magunguna, iyakance gishiri a cikin abincinsu yana taimakawa. Yi ƙoƙarin rage yawan ci na sodium chloride, i.e. gishirin tebur, da kimanta wane sakamakon da kuka samu. Kowane mutum yana da nasu hankalin game da gishiri.
Wani rikitarwa, neuropathy na ciwon sukari, na iya lalata jijiyoyin da ke kula da mafitsara. A wannan yanayin, aikin lalata mafitsara yana da illa. A cikin fitsari, wanda ya kasance koyaushe, kamuwa da cuta wanda ke cutar da ƙodan zai iya ƙaruwa. A lokaci guda, a cikin masu ciwon sukari waɗanda suka sami damar daidaita sukarin jininsu, neuropathy sau da yawa yakan zama mai juyawa, watau, wuce gaba ɗaya.
Idan kuna fuskantar wahala urinating ko wasu alamun cututtukan urinary fili, duba likitan ku kai tsaye. Wadannan matsalolin na iya hanzarta hanzarta ci gaban duniyan da ake samu a cikin masu ciwon suga.
