Ciwon rashin lafiya

Ciwon hepatorenal wani yanayi ne wanda a cikin sa ake samun ciwan koda wanda ke faruwa ga mutum mai cutar hanta. Babban matsala ne wanda zai iya haifar da mutuwa.

Ciwon hepatorenal yana faruwa lokacin da kodan suka daina aiki da kyau a cikin mutane masu fama da matsalolin hanta. Ana cire karancin fitsari daga jiki, saboda haka kayayyakin ɓarnatar da ke ɗauke da sinadarin nitrogen suna taruwa a cikin jini (azotemia).

Rashin lafiyar yana faruwa har zuwa 1 cikin 10 mutane waɗanda ke cikin asibiti tare da gazawar hanta. Yana haifar da gazawar koda a cikin mutane masu:

• Failurearancin hanta
• Ciwan giya
• Ciwan Cirrhosis
• Ciwon ruwan ciki

Hanyoyin haɗari sun haɗa da:

• Ruwan jini wanda yake sauka yayin da mutum ya tashi ko kuma ya canza wuri kwatsam (orthostatic hypotension)
• Amfani da magunguna da ake kira diuretics ("kwayoyi na ruwa")
• Zuban jini na ciki
• Kamuwa da cuta
• Cire ruwan cikin kwanan nan (paracentesis)

Kwayar cutar sun hada da:

• Ciwan ciki saboda ruwa (wanda ake kira ascites, alama ce ta cutar hanta)
• Rikicewar hankali
• Clearjin tsoka
• Fitsari mai duhu (alama ce ta cutar hanta)
• Rage fitowar fitsari
• Tashin zuciya da amai
• Karuwar nauyi
• Fatar rawaya (jaundice, alama ce ta cutar hanta)

Ana gano wannan yanayin bayan gwaji don kawar da wasu dalilai na gazawar koda.

Gwajin jiki baya gano gazawar koda kai tsaye. Koyaya, gwajin zai nuna alamun cutar hanta na yau da kullun, kamar su:

• Rikicewa (galibi saboda ciwon hanta)
• Ruwa mai yawa a cikin ciki (ascites)
• Jaundice
• Sauran alamun gazawar hanta

Sauran alamun sun hada da:

• Abubuwa mara kyau
• Testananan ƙwayoyin cuta
• Dara mara sauti a cikin yankin lokacin da aka taɓa ta da yatsun yatsun
• Tissueara ƙwayar nono (gynecomastia)
• Ciwo (rauni) akan fata

Mai zuwa na iya zama alamun gazawar koda:

• Kadan ne ko babu fitowar fitsari
• Rike ruwa a cikin ciki ko tsauraran matakai
• Bara BUN da matakan jini na halitta
• Urineara yawan fitsari takamaimai nauyi da osmolality
• Diumananan sodium
• Lowananan ƙwayar fitsarin sodium

Mai zuwa na iya zama alamun gazawar hanta:

• Cikakken lokacin prothrombin (PT)
• Levelara matakin ammoniya na jini
• Albarancin albumin
• Paracentesis yana nuna ascites
• Alamun cutar hanta (ana iya yin EEG)

Manufar magani ita ce taimakawa hanta aiki sosai da kuma tabbatar da cewa zuciya za ta iya fitar da isasshen jini a jiki.

Jiyya daidai yake da na gazawar koda daga kowane dalili. Ya hada da:

• Dakatar da duk magungunan da basu dace ba, musamman ibuprofen da sauran NSAIDs, wasu maganin rigakafi, da diuretics ("kwayar ruwa")
• Samun dialysis don inganta bayyanar cututtuka
• Shan magunguna dan inganta hawan jini da taimakawa kodan ku suyi aiki sosai; jiko na albumin na iya zama da taimako
• Sanya shunt (wanda aka sani da TIPS) don taimakawa bayyanar cututtuka na ascites (wannan na iya taimakawa aikin koda, amma hanya na iya zama haɗari)
• Yin aikin tiyata don sanya shunt daga sararin ciki zuwa jijiyar jugular don taimakawa wasu alamun bayyanar gazawar koda (wannan aikin yana da haɗari kuma ba safai ake yin sa ba)

Sakamakon ba shi da kyau. Mutuwar takan faru ne sau da yawa saboda kamuwa da cuta ko zubar jini mai tsanani (zubar jini).

Matsaloli na iya haɗawa da:

• Zuban jini
• Lalacewa ga, da rashin cin nasara, yawancin gabobin jiki
• Kidneyarshen-koda cuta
• Ara yawan ruwa da kuma gazawar zuciya
• Coma ya haifar da gazawar hanta
• Cututtukan sakandare

Wannan cuta galibi ana gano ta a asibiti yayin magani don cutar hanta.

Cirrhosis - rashin lafiya; Rashin hanta - hepatorenal

Fernandez J, Arroyo V. Ciwon rashin lafiya. A cikin: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. M Clinical Nephrology. Na 6 ed. Philadelphia, PA: Elsevier; 2019: babi na 73.

Garcia-Tsao G. Cirrhosis da kuma bayanansa. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 144.

Mehta SS, Fallon MB. Ciwon hanta na hanta, cututtukan hanta, cututtukan hanta, da sauran rikice-rikicen tsarin cutar hanta. A cikin: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger da Cututtukan Cutar hanta da na Fordtran. 11th ed. Philadelphia, PA: Elsevier; 2021: babi na 94.