Isifo sikashukela i-insipidus sibonakala ngokukhiqizwa ngokweqile komchamo okuhambisana nokoma okukhulu. Kungenzeka ukuhlukanisa izinhlobo eziningana, ezivame kakhulu kuzo i-neurogenic diabetes insipidus kanye ne-nephrogenic diabetes insipidus. Lezi azinazo izici ezifanayo ncamashi kodwa zombili zibonisa inkinga yokulawula ezinso. Umzimba awuwagcini amanzi anele ukumboza izidingo zawo.

Incazelo yesifo sikashukela i-insipidus

Isifo sikashukela i-insipidus kungumphumela wokushoda noma ukungazweli kwi-hormone elwa namagciwane: i-vasopressin. Njengengxenye yokusebenza okujwayelekile komzimba, le hormone ikhiqizwa ku-hypothalamus bese igcinwa kuyi-pituitary gland. Ngemuva kwalezi zinyathelo ezimbili ebuchosheni, i-vasopressin ikhishwa emzimbeni ukulawula inani lamanzi emzimbeni. Izosebenza ezinso ukuvuselela amanzi ahlungiwe, futhi ngaleyo ndlela ivikele ukuqedwa kwawo emchameni. Ngale ndlela, kuyasiza ukumboza izidingo zamanzi zomzimba.

Ku-insipidus yesifo sikashukela, i-vasopressin ayikwazi ukudlala indima yayo njenge-ejenti elwa namagciwane. Amanzi akhishwa ngokweqile, okuholela ekukhiqizeni ngokweqile komchamo okuhambisana nokoma okukhulu.

Izinhlobo zesifo sikashukela insipidus

Izindlela ezihilelekile ku-diabetes insipidus azifani ngaso sonke isikhathi. Kungakho kungenzeka ukuhlukanisa amafomu amaningi:

• I-neurogenic, noma isifo sikashukela esiphakathi insipidus, esibangelwa ukukhululwa okwanele kwe-hormone ye-antidiuretic ku-hypothalamus;
• i-nephrogenic, noma i-peripheral, isifo sikashukela i-insipidus, esibangelwa ukungezwani kwezinso ku-antidiuretic hormone;
• gestational diabetes insipidus, okuwuhlobo olungavamile okwenzeka ngesikhathi sokukhulelwa okuvame ukuba umphumela wokuwohloka kwe-vasopressin egazini;
• I-dipsogenic diabetes insipidus ebonakala ngokuphazamiseka kwendlela yokoma ku-hypothalamus.

Izinkinga zesifo sikashukela i-insipidus

Kulesi sigaba, kufanele kuqashelwe ukuthi isifo sikashukela i-insipidus singaba sokuzalwa (esikhona kusukela ekuzalweni), sitholwe (ngokulandela imingcele yangaphandle) noma i-idiopathic (ngesizathu esingaziwa).

Ezinye zezimbangela ezikhonjwe kuze kube yimanje zifaka:

• ukuhlukumezeka ekhanda noma ukulimala kwengqondo;
• ukuhlinzwa kobuchopho;
• ukulimala kwemithambo yegazi njenge-aneurysms (ukunwetshwa okwenziwe kwasendaweni kodonga lwe-artery) ne-thrombosis (ukwakheka kwegazi);
• izinhlobo ezithile zomdlavuza kuhlanganise nezimila ebuchosheni;
• izifo ezizimele;
• izifo zesimiso sezinzwa ezifana ne-encephalitis ne-meningitis;
• isifo sofuba;
• i-sarcoidosis;
• isifo sezinso se-polycystic (ukuba khona kwama-cysts ezinso);
• i-sickle cell anemia;
• i-sponge medullary kidney (isifo sezinso sokuzalwa);
• i-pyelonephritis enzima;
• i-amylose;
• i-Sjögren syndrome;
• njll

Ukuxilongwa kwesifo sikashukela i-insipidus

Isifo sikashukela i-insipidus siyasolwa uma kukhishwa inani elikhulu lomchamo ohambisana nokoma ngokweqile. Ukuqinisekiswa kokuxilongwa kungasuselwa ku:

• ukuhlolwa kokuvinjelwa kwamanzi okukala ukuphuma komchamo, ukugxila kwe-electrolyte yegazi nesisindo ngezikhathi ezijwayelekile;
• ukuhlolwa komchamo ukuhlola umchamo ushukela (isici sikashukela mellitus);
• ukuhlolwa kwegazi ukukhomba ikakhulukazi ukuhlushwa kwe-sodium ephezulu.

Ngokuya ngecala, ezinye izivivinyo ezengeziwe zingase zicatshangelwe ukuze kutholakale imbangela yesifo sikashukela i-insipidus.

Amacala amaningi esifo sikashukela insipidus azuzwa njengefa. Umlando womndeni wesifo sikashukela i-insipidus uyingozi enkulu.

• I-Polyuria: Enye yezimpawu ezijwayelekile zesifo sikashukela i-insipidus i-polyuria. Lokhu ukukhiqiza umchamo oweqile odlula amalitha ama-3 ngosuku futhi ungafinyelela kumalitha angama-30 ezimeni ezinzima kakhulu.
• I-Polydispsia: Uphawu lwesibili lwesici yi-polydipsia. Kungumqondo wokoma okukhulu phakathi kwamalitha ama-3 kuya kwangama-30 ngosuku.
• I-nocturia engenzeka: Kujwayelekile ukuthi i-polyuria ne-polydipsia ihambisane ne-nocturia, isidingo sokuchama ebusuku.
• Ukuphelelwa amanzi emzimbeni: Uma kungekho ukuphathwa okufanele, isifo sikashukela i-insipidus singabangela ukuphelelwa amanzi emzimbeni kanye nokukhubazeka kokusebenza komzimba. I-Hypotension kanye nokushaqeka kungase kubonakale.

Ukuphatha kuncike kumingcele eminingi kufaka phakathi uhlobo lwesifo sikashukela i-insipidus. Ingase ikakhulukazi ihlanganise:

• i-hydration eyanele;
• ukunciphisa ukusetshenziswa kosawoti wokudla kanye namaprotheni;
• ukuphathwa kwe-vasopressin noma izinhlobo ezifanayo ezifana ne-desmopressin;
• ukuphathwa kwama-molecule akhuthaza ukukhiqizwa kwe-vasopressin njenge-thiazide diuretics, i-chlorpropamide, i-carbamazepine, noma i-clofibrate;
• ukwelashwa okuqondile okuqondise imbangela ekhonjiwe.

Kuze kube manje, asikho isisombululo sokuvikela esesitholakele. Ezimweni eziningi, isifo sikashukela i-insipidus sitholwa njengefa.