Izinso (ezivela ku-Latin ren, renis) izitho eziyingxenye yohlelo lomchamo. Baqinisekisa ukuhlungwa kwegazi ngokususa imfucuza ekulo ngokukhiqizwa komchamo. Zibuye zigcine amanzi kanye namaminerali emzimbeni.

Ama-nothings, amabili ngenombolo, atholakala engxenyeni engemuva yesisu ezingeni lezimbambo ezimbili zokugcina, ohlangothini ngalunye lomgogodla. Izinso ezingakwesokudla, ezitholakala ngaphansi kwesibindi, ziphansi kancane kunesokunxele, ezitholakala ngaphansi kobende.

Inso ngayinye, emise okwebhontshisi, ilinganiselwa ku-12 cm ubude, 6 cm ububanzi no-3 cm ukujiya. Bazungezwe yindlala ye-adrenal, isitho sohlelo lwe-endocrine futhi esingabandakanyi emsebenzini womchamo. Zizungezwe ngalinye ligobolondo langaphandle elivikelayo, i-capsule eyindilinga.

Ingaphakathi lezinso lihlukaniswe izingxenye ezintathu (kusuka ngaphandle kuya ngaphakathi):

• I-cortex, ingxenye engaphandle kakhulu. Iphaphathekile ngombala futhi ingu-1 cm ubukhulu, imboza i-medulla.
• I-medulla, maphakathi nendawo, ibomvu ngokubomvu ngombala. Iqukethe izigidi zamayunithi okuhlunga, ama-nephrons. Lezi zakhiwo zine-glomerulus, i-sphere encane lapho ukuhlunga kwegazi nokukhiqizwa komchamo kwenzeka. Futhi aqukethe ama-tubules abandakanyeka ngokuqondile ekuguquleni ukwakheka komchamo.
• Ama-calyce kanye ne-pelvis yizimbobo eziqoqa umchamo. Ama-calyce athola umchamo kuma-nephrons bese utheleka okhalweni. Umchamo ube usugeleza nge-ureters uye esinyeni, lapho uzogcinwa khona ngaphambi kokuba ukhishwe.

Unqenqema lwangaphakathi lwezinso luphawulwa ngonotshi, i-renal hilum lapho imithambo yegazi yezinso nezinzwa kanye ne-ureter iphela. Igazi "elisetshenzisiwe" lifika ezinso ngokusebenzisa umthambo we-renal, okuyigatsha le-aorta yesisu. Lo mthambo wezinso ube usuhlukana phakathi ezinso. Igazi eliphumayo lithunyelwa ku-vena cava engaphansi ngomthambo wezinso. Izinso zithola amalitha angu-1,2 egazi ngomzuzu, okungaba ingxenye yesine yesamba segazi eliphelele.

Uma kwenzeka kwenzeka i-pathologies, inso elilodwa kuphela elingenza imisebenzi yezinso.

Izinso zinemisebenzi emine esemqoka:

• Ukuthuthukiswa komchamo kusukela ekuhlungeni igazi. Lapho igazi lifika ezinsweni ngomthambo wezinso, lidlula kuma- nephrons lapho likhishwa khona izinto ezithile. Imfucumfucu (i-urea, i-uric acid noma i-creatinine nezinsalela zezidakamizwa) kanye nezakhi ezidlulele zikhishwa emchamweni. Lokhu kuhlunga kwenza kube nokwenzeka ngesikhathi esifanayo ukulawula okuqukethwe kwamanzi ne-ion (i-sodium, i-potassium, i-calcium, njll.) egazini futhi kugcinwe ibhalansi. Emahoreni angama-24, amalitha ayi-150 kuya kwayi-180 eplasma yegazi ayahlungwa ukuze kukhiqizwe cishe ilitha elingu-1 kuya ku-1,8 womchamo. Umchamo ekugcineni wakhiwe ngamanzi kanye ne-solutes (i-sodium, i-potassium, i-urea, i-creatinine, njll.). Ezinye izinto azikho, esigulini esinempilo, emchameni (ushukela, amaprotheni, amangqamuzana egazi abomvu, amangqamuzana egazi amhlophe, i-bile).
• Uketshezi lwe-renin, i-enzyme esiza ukulawula umfutho wegazi.
• Ukukhiqizwa kwe-erythropoietin (EPO), i-hormone ekhuthaza ukwakheka kwamangqamuzana abomvu egazi emnkantsheni.
• Ukuguqulwa kwe-vitamin D ibe ifomu layo elisebenzayo.

Amatshe ezinso (amatshe ezinso) : okuvame ukubizwa ngokuthi "amatshe ezinso", lawa amakristalu aqinile akha ezinso futhi angadala ubuhlungu obukhulu. Cishe ku-90% wamacala, amatshe we-urinary akha ngaphakathi kwezinso. Usayizi wazo uyahlukahluka kakhulu, kusuka kumamilimitha ambalwa kuya kumasentimitha ambalwa ububanzi. Itshe elenziwe ezinso nasekuthutheleni esinyeni lingavimba kalula i-ureter futhi lidale ubuhlungu obukhulu. Lokhu kubizwa ngokuthi i-renal colic.

Ukonakala :

Ukungasebenzi kahle kwezinso : i-congenital anomaly engathinta inso eyodwa kuphela noma zombili. Ngesikhathi sokukhula kombungu, izinso zikhuphula ikholomu ziye endaweni yalo yokugcina bese zijikeleza. Endabeni yale pathology, ukujikeleza akwenziwa ngendlela efanele. Ngenxa yalokho, i-pelvis, evame ukutholakala emaphethelweni angaphakathi angenalutho, itholakala ebusweni bayo bangaphambili. Ukungahambi kahle kube okungahambi kahle, umsebenzi wezinso uqinile.

Ukuphindaphinda kwezinso : i-anomaly yokuzalwa engavamile, ihambisana nokuba khona kwezinso ezengeziwe ohlangothini olulodwa lomzimba. Le nso izimele, ine-vascularity yayo kanye ne-ureter yayo eholela ngqo esinyeni noma ehlangana ne-ureter yenso ohlangothini olulodwa.

I-Hydronéphrose : kungukunwetshwa kwama-calyces nesinqe. Lokhu kukhuphuka kwevolumu yale mibobo kungenxa yokuncipha noma ukuvimba kwe-ureter (malformation, lithiasis…) okuvimbela umchamo ukuba ungagezi.

Izinso zesicathulo samahhashi : ukonakala okubangelwa ukuhlangana kwezinso ezimbili, ngokuvamile ngesigxobo sazo esingaphansi. Le nso itholakala ngaphansi kwezinso ezivamile futhi i-ureters ayithinteki. Lesi simo asiholeli kunoma yimiphi imiphumela ye-pathological, ngokuvamile kubonakala ngengozi ngesikhathi sokuhlolwa kwe-X-ray.

Ukungajwayelekile kokusebenza kwezinso :

Ukuhluleka kwe-renal acute futhi okungamahlalakhona : ukuwohloka kancane kancane nokungenakulungiseka kwekhono lezinso lokuhlunga igazi nokukhipha amahomoni athile. Imikhiqizo ye-metabolism kanye namanzi amaningi adlula kancane kancane emchameni futhi anqwabelene emzimbeni. Isifo sezinso esingamahlalakhona sibangelwa izinkinga zesifo sikashukela, umfutho wegazi ophakeme, noma ezinye izifo. Ngakolunye uhlangothi, ukwehluleka kwezinso okunamandla kuvela ngokuzumayo. Kuvame ukuvela ngenxa yokwehla okubuyiselwe emuva kokugeleza kwegazi kwezinso (ukuphelelwa amanzi emzimbeni, ukutheleleka okunzima, njll.). Iziguli zingazuza ku-hemodialysis zisebenzisa izinso zokwenziwa.

I-Glomerulonephritis : ukuvuvukala noma ukulimala kwe-glomeruli yezinso. Ukuhlungwa kwegazi akusasebenzi kahle, amaprotheni namaseli abomvu egazi bese kutholakala emchameni. Sihlukanisa phakathi kwe-glomerulonephritis eyinhloko (kuthinteka ama-nothings kuphela) kusuka ku-glomerulonephritis yesibili (umphumela wesinye isifo). Imvamisa yesizathu esingaziwa, kukhonjisiwe ukuthi i-glomerulonephritis, ngokwesibonelo, ingavela ngokulandela ukutheleleka, ukuphuza imishanguzo ethile (isb.

Izifo

I-Pyelonephritis : ukutheleleka kwezinso ngamagciwane. Ezimweni eziningi, lokhu kunjaloEscherichia Coli, obhekene no-75 kuya ku-90% we-cystitis (ukutheleleka komgudu womchamo), okwanda esinyeni futhi kukhuphukele ezinsoweni ngokusebenzisa i-ureters (8). Abesifazane, ikakhulukazi abesifazane abakhulelwe, basengozini enkulu. Izimpawu ziyefana ne-cystitis ehambisana nomkhuhlane nezinhlungu ezisezingeni eliphansi. Ukwelashwa kwenziwa ngokuthatha ama-antibiotics.

Izimila ze-Benign

I-Cyst : I-cyst yezinso iphakethe loketshezi olwakha ezinso. Okuvame kakhulu ama-cysts alula (noma awodwa). Azibangeli izinkinga noma izimpawu. Iningi labo alinomdlavuza, kepha ezinye zingaphazamisa ukusebenza kwesitho bese zibangela ubuhlungu.

Isifo sePolycystic : isifo sofuzo esibonakala ngokwanda kwenqwaba yama-cyst renal. Lesi simo singaholela ekutheni umfutho wegazi ophakeme wehluleke ukusebenza nezinso.

Izimila ezimbi 

Umdlavuza wezinso : imele cishe u-3% womdlavuza futhi ithinta abesilisa abaphindwe kabili kunabesifazane (9). Umdlavuza wenzeka lapho amaseli athile ezinso eguquka, ephindaphindeka ngendlela enehaba futhi engalawulwa, bese enza isimila esibi. Ezimweni eziningi, umdlavuza wezinso utholakala ngengozi lapho kuhlolwa isisu.

Prevention. Ukuvikela izinso zakho kubalulekile. Nakuba ezinye izifo zingenakuvinjelwa ngokuphelele, imikhuba yokuphila enempilo inganciphisa ingozi. Ngokuvamile, ukuhlala unamanzi amaningi (okungenani amalitha ama-2 ngosuku) nokulawula ukudla kwakho usawoti (ngokudla nangomdlalo) kuyasiza ekusebenzeni kwezinso.

Ezinye izinyathelo eziqondile ziyanconywa ukunciphisa ingozi noma ukuvimbela ukuphindeka kwamatshe ezinso.

Endabeni yokuhluleka ukusebenza kwezinso, izimbangela ezimbili ezinkulu yisifo sikashukela (uhlobo 1 no-2) kanye nomfutho wegazi ophezulu. Ukulawulwa kahle kwalezi zifo kunciphisa kakhulu ubungozi bokuthuthukela ecaleni lokunganele. Okunye ukuziphatha, njengokugwema uphuzo oludakayo, ukusebenzisa kabi izidakamizwa nemithi, kungasinqanda lesi sifo.

Umdlavuza wezinso. Izici eziyingozi kakhulu ukubhema, ukukhuluphala ngokweqile noma ukukhuluphala, nokungabi nayo i-dialysis isikhathi esingaphezu kweminyaka emithathu. Lezi zimo zingakhuthaza ukuthuthukiswa komdlavuza (10).

Izivivinyo zelebhu : Ukunqunywa kwezinto ezithile egazini nasemchameni kuvumela ukuthi umsebenzi wezinso uhlolwe. Lokhu kunjalo, isibonelo, i-creatinine, i-urea namaprotheni. Endabeni ye-pyelonephritis, ukuhlolwa kwe-cytobacteriological yomchamo (i-ECBU) kunqunyiwe ukunquma amagciwane abandakanyeka ekuthelelekeni bese kulungiswa ukwelashwa.

I-Biopsy: ukuhlolwa okubandakanya ukuthatha isampula yezinso kusetshenziswa inaliti. Ucezu olususiwe luhlolwa nge-microscopic kanye/noma nokuhlaziywa kwamakhemikhali ezinto eziphilayo ukuze kutholwe ukuthi lunomdlavuza yini.

AMAPOSA 

I-Ultrasound: inqubo yokuthwebula encike ekusetshenzisweni kwe-ultrasound ukubona ngeso lengqondo ukwakheka kwangaphakathi kwesitho. I-Ultrasound yesistimu yomchamo ivumela ukubonwa kwezinso kodwa kanye nama-ureters kanye nesinye. Isetshenziselwa ukugqamisa, phakathi kwezinye izinto, ukungasebenzi kahle kwezinso, ukungasebenzi kahle, i-pyelonephritis (ehlotshaniswa ne-ECBU) noma itshe lezinso.

I-Uroscanner: inqubo ye-imaging equkethe "ukuskena" isifunda esinikeziwe somzimba ukuze wakhe izithombe ezinqamulelayo, ngenxa yokusetshenziswa kogongolo lwe-X-ray. Kwenza kube nokwenzeka ukubona yonke idivayisi umgudu womchamo (izinso, i-excretory tract, isinye, i-prostate) uma kwenzeka i-pathology yezinso (umdlavuza, i-lithiasis, i-hydronephrosis, njll.). Iya ngokuya ithatha indawo ye-urography ye-intravenous.

I-MRI (i-magnetic resonance imaging): ukuhlolwa kwezokwelapha ngezinjongo zokuxilonga okwenziwa kusetshenziswa isisetshenziswa esikhulu esiyicylindrical lapho kukhiqizwa khona indawo kazibuthe namaza omsakazo. Kwenza kube nokwenzeka ukuthola izithombe ezinembe kakhulu kuzo zonke izilinganiso ze-urinary tract esimweni se-MRI yendawo ye-abdomino-pelvic. Kusetshenziswa ikakhulukazi ukuveza isimila noma ukwenza umdlavuza.

I-Intravenous urography: Ukuhlolwa kwe-X-ray okwenza kube nokwenzeka ukubona ngeso lengqondo lonke uhlelo lokuchama (izinso, isinye, i-urethra kanye ne-urethra) ngemva kokujova umkhiqizo opaque kuma-X-reyi agxile emchamweni. Le nqubo ingasetshenziswa ikakhulukazi uma kwenzeka i-lithiasis noma ukuqhathanisa ukusebenza kwezinso.

I-Kidney scintigraphy: lena indlela yokuthwebula izithombe ehlanganisa ukunikeza isiguli umkhondo okhipha imisebe, osakazeka ezinso. Lokhu kuhlola kusetshenziselwa ikakhulukazi ukukala ukusebenza kwezinso, ukubona ngeso lengqondo i-morphology noma ukuhlola i-sequelae ye-pyelonephritis.

Emithi yaseShayina, imizwa emihlanu eyisisekelo ngayinye ixhunywe esithweni esisodwa noma ngaphezulu. Ukwesaba kuhlotshaniswa ngqo nezinso.