{"id":451871,"date":"2021-05-23T07:59:43","date_gmt":"2021-05-23T05:59:43","guid":{"rendered":"https:\/\/hashtag.al\/?p=451871"},"modified":"2021-05-21T22:48:09","modified_gmt":"2021-05-21T20:48:09","slug":"mjekimi-pa-barna-i-semundjeve-te-veshkave","status":"publish","type":"post","link":"https:\/\/www.hashtag.al\/index.php\/2021\/05\/23\/mjekimi-pa-barna-i-semundjeve-te-veshkave\/","title":{"rendered":"Mjekimi pa barna i s\u00ebmundjeve t\u00eb veshkave","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"

\"\"<\/a><\/p>\n

Nga Alketa Koroshi, mjeke nefrologe<\/span><\/strong><\/p>\n

S\u00ebmundjet kronike t\u00eb veshkave p\u00ebrb\u00ebjn\u00eb shumic\u00ebn d\u00ebrmuese t\u00eb s\u00ebmundjeve t\u00eb veshkave n\u00eb p\u00ebrgjith\u00ebsi. Ato jan\u00eb mjaft t\u00eb p\u00ebrhapura n\u00eb t\u00eb gjitha vendet.<\/span>
\nN\u00eb bot\u00eb jan\u00eb mbi 800 milion\u00eb njer\u00ebz q\u00eb vuajn\u00eb nga s\u00ebmundjet e veshkave. \u00c7do vit vdesin nga s\u00ebmundjet e veshkave afro 950 mij\u00eb njer\u00ebz n\u00eb rruzullin tok\u00ebsor. Jan\u00eb gati 1,5 milion\u00eb njer\u00ebz q\u00eb b\u00ebjn\u00eb Dializ\u00eb p\u00ebr shkak t\u00eb humbjes p\u00ebrfundimtare t\u00eb funksionit t\u00eb veshkave. N\u00eb Shqip\u00ebri \u00ebsht\u00eb llogaritur q\u00eb jan\u00eb afro 300 mij\u00eb njer\u00ebz me s\u00ebmundje kronike t\u00eb veshkave dhe jan\u00eb mbi 900 vet\u00eb q\u00eb b\u00ebjn\u00eb Dializ\u00eb.<\/span><\/p>\n

Shpesht\u00ebsia e s\u00ebmundjeve t\u00eb veshkave n\u00eb koh\u00ebn e sotme lidhet me p\u00ebrhapjen m\u00eb t\u00eb madhe t\u00eb s\u00ebmundjeve t\u00eb tilla si diabeti dhe hipertensioni, q\u00eb p\u00ebrb\u00ebjn\u00eb edhe shkakun kryesor t\u00eb prekjes dhe d\u00ebmtimit t\u00eb veshkave. Pa dyshim n\u00eb to ndikojn\u00eb ndryshimi i m\u00ebnyr\u00ebs s\u00eb jetes\u00ebs, jeta sedentare, obeziteti, dietat me shum\u00eb krip\u00eb, stresi, duhani etj.<\/span>
\nDuhet th\u00ebn\u00eb se edhe gjendja e v\u00ebshtir\u00eb sociale dhe ekonomike favorizon p\u00ebrhapjen e tyre.<\/span><\/p>\n

Simptomat<\/span><\/strong>
\nK\u00ebto s\u00ebmundje kronike t\u00eb veshkave q\u00eb n\u00eb popull njihen me termin \u201cazotemi\u201d kan\u00eb si karakteristike q\u00eb n\u00eb stadet e hershme jan\u00eb pa simptoma.<\/span>
\nShum\u00eb her\u00eb jan\u00eb analizat e gjakut e t\u00eb urin\u00ebs q\u00eb evidentojn\u00eb nj\u00eb rritje t\u00eb leht\u00eb t\u00eb kreatinin\u00ebs e t\u00eb ures\u00eb n\u00eb gjakun periferik apo rrithje t\u00eb albumin\u00ebs n\u00eb analizat e urin\u00ebs.<\/span><\/p>\n

Zbulimi i hersh\u00ebm i s\u00ebmundjes<\/span><\/strong>
\nNga ana tjet\u00ebr, zbulimi i hersh\u00ebm i k\u00ebtyre s\u00ebmundjeve \u00ebsht\u00eb me shum\u00eb r\u00ebnd\u00ebsi p\u00ebr t\u00eb parandaluar progresionin e s\u00ebmundjes, simptomat klinike t\u00eb shprehura dhe rrezikun e futjes n\u00eb dializ\u00eb, si\u00e7 ndodh n\u00eb stadet e p\u00ebrparuara t\u00eb k\u00ebtyre patologjive.<\/span>
\nDuhet ditur q\u00eb nj\u00eb nga rreziqet m\u00eb t\u00eb m\u00ebdha t\u00eb pacienteve me s\u00ebmundje t\u00eb veshkave \u00ebsht\u00eb d\u00ebmtimi kardiovaskular dometh\u00ebn\u00eb prekja nga s\u00ebmundjet koronare, infarkti i miokardit dhe insulti cerebrale. K\u00ebto jan\u00eb komplikacione q\u00eb jo vet\u00ebm e invalidizojn\u00eb t\u00eb s\u00ebmurin por q\u00eb p\u00ebrb\u00ebjn\u00eb rrezik p\u00ebr jet\u00ebn m\u00eb shum\u00eb madje se vet\u00eb insuficienca renale (d\u00ebmtimi i veshkave).<\/span>
\nP\u00ebr k\u00ebto arsye mbajtja dhe ruajtja e sh\u00ebndetit t\u00eb veshkave \u00ebsht\u00eb sot nj\u00eb prioritet global n\u00eb mjek\u00ebsi.<\/span><\/p>\n

R\u00ebnd\u00ebsia e kujdesit p\u00ebr veshkat<\/span><\/strong>
\nKujdesi p\u00ebr veshkat lidhet me rolin vital (jet\u00ebsor) q\u00eb k\u00ebto organe kan\u00eb p\u00ebr trupin e njeriut. Veshkat normalisht kryejn\u00eb filtrimin e gjakut duke eliminuar me an\u00eb t\u00eb urin\u00ebs produktet e d\u00ebmshme dhe t\u00eb tep\u00ebrta t\u00eb metabolizmit t\u00eb t\u00eb gjitha indeve dhe qelizave t\u00eb trupit t\u00eb njeriut. Veshkat mbajn\u00eb ekuilibrin e l\u00ebngjeve dhe t\u00eb krip\u00ebrave n\u00eb organiz\u00ebm si t\u00eb natriumit, t\u00eb kaliumit, t\u00eb kalciumit, t\u00eb fosforit etj. Ato gjithashtu kontrollojn\u00eb presionin e gjakut (tensionin arterial) n\u00ebp\u00ebrmjet \u00e7lirimit sipas nevojave t\u00eb disa lloj hormoneve (si\u00e7 \u00ebsht\u00eb renina e angiotensina) q\u00eb ruajn\u00eb tensionin e gjakut n\u00eb parametra normale deri 120\/80 mmHg.<\/span><\/p>\n

Gjithashtu veshkat stimulojn\u00eb prodhimin e rruazave t\u00eb kuqe t\u00eb gjakut n\u00ebp\u00ebrmjet \u00e7lirimit t\u00eb nj\u00eb hormoni t\u00eb r\u00ebnd\u00ebsish\u00ebm si eritropoetina. K\u00ebshtu n\u00eb pacientet me deficit t\u00eb funksionit t\u00eb veshkave \u00e7lirimi i mang\u00ebt e k\u00ebtij hormoni b\u00ebn q\u00eb t\u00eb zhvillohet anemia e k\u00ebtyre pacienteve t\u00eb cil\u00ebt q\u00eb n\u00eb pamjen e par\u00eb duken t\u00eb zbeht\u00eb e jan\u00eb t\u00eb lodhur. Ve\u00e7 asaj veshka luajn\u00eb rol edhe n\u00eb ruajtjen e sh\u00ebndetit t\u00eb kockave n\u00ebp\u00ebrmjet aktivizimit t\u00eb vitamin\u00ebs D, dhe kjo ndodh n\u00eb tulin (parenkimen) e veshk\u00ebs.<\/span><\/p>\n

Trajtimi<\/span><\/strong>
\nN\u00eb trajtimin e s\u00ebmundjeve t\u00eb veshkave nuk marrin pjes\u00eb vet\u00ebm nefrolog\u00ebt e specializuar p\u00ebr k\u00ebto s\u00ebmundje p\u00ebr edhe mjek\u00ebt e kujdesit par\u00ebsor. Mjek\u00ebt duhet t\u00eb njohin konditat ku jeton i s\u00ebmuri, t\u00eb p\u00ebrcaktojn\u00eb kush jan\u00eb faktor\u00ebt q\u00eb rrezikojn\u00eb p\u00ebr d\u00ebmtimin e veshkave, duhet t\u00eb komunikojn\u00eb me pacientin dhe t\u2019i tregojn\u00eb atij me durim se \u00e7far\u00eb diagnoze ka e \u00e7far\u00eb masash duhen marr\u00eb p\u00ebr trajtimin e saj.<\/span><\/p>\n

Mjekimi i s\u00ebmundjeve t\u00eb veshkave b\u00ebhet s\u00eb pari me trajtimin pa ila\u00e7e (pa barna) e s\u00eb dyti me terapin\u00eb farmakologjike me barna.<\/span>
\nFillimisht duhet ditur q\u00eb \u00e7do nj\u00ebri n\u00eb mosh\u00ebn e rritur duhet q\u00eb nj\u00eb her\u00eb n\u00eb vit t\u00eb kontrolloj\u00eb nivelin e kreatinin\u00ebs dhe t\u00eb ures\u00eb n\u00eb gjak. Po ashtu t\u00eb b\u00ebje analiz\u00ebn e urin\u00ebs p\u00ebr t\u00eb par\u00eb n\u00ebse ka albumin\u00eb n\u00eb t\u00eb. Pacient\u00ebt q\u00eb tashme e kan\u00eb diagnoz\u00ebn e s\u00ebmundjes kronike t\u00eb veshkave qoft\u00eb edhe n\u00eb stadet e lehta duhet q\u00eb k\u00ebto analiza t\u2019i b\u00ebjn\u00eb dy-tre her\u00eb n\u00eb vit p\u00ebr t\u00eb vler\u00ebsuar ecurin\u00eb e s\u00ebmundjes.<\/span><\/p>\n

Pacienti duhet t\u00eb kontrolloj\u00eb nivelin e tensionit arterial, t\u00eb yndyrnave dhe t\u00eb sheqerit.<\/span><\/p>\n

Pacienti duhet t\u2019i kushtoj\u00eb kujdes diet\u00ebs ushqimore. Duhen evituar kalorit\u00eb e tep\u00ebrta (1800-2000 kalori n\u00eb 24 or\u00eb, ose 30-35 kal \/kg pesh\u00eb\/dit\u00eb). Duhet evituar obeziteti dhe jeta sedentare. Duhet evituar ushqimi me yndyrna t\u00eb tep\u00ebrta t\u00eb ngopura dhe ushqimet e p\u00ebrpunuara industrialisht. Ato kan\u00eb shum\u00eb krip\u00eb dhe shum\u00eb fosfor. Dieta m\u00eb e mir\u00eb \u00ebsht\u00eb dieta mesdhetare q\u00eb p\u00ebrmban vaj ulliri e perime, pak mish, sidomos shum\u00eb pak mish t\u00eb kuq. Dieta mesdhetare kombinon marrjen e fibrave me ushqyes t\u00eb dobish\u00ebm (kalium dhe acide yndyrore t\u00eb pangopura).<\/span><\/p>\n

Qysh disa dekada m\u00eb par\u00eb \u00ebsht\u00eb par\u00eb se kufizimi i proteinave n\u00eb diet\u00eb e ngadal\u00ebson progresionin e s\u00ebmundjeve t\u00eb veshkave. Mir\u00eb \u00ebsht\u00eb q\u00eb pacientet me s\u00ebmundje t\u00eb veshkave me kreatinin\u00ebn t\u00eb rritur qoft\u00eb edhe pak, t\u00eb marrin 0,8 gr\/kg pesh\u00eb n\u00eb dit\u00eb proteina. Dieta me pak proteina ndikon n\u00eb uljen e tensionit arterial dhe sidomos n\u00eb pak\u00ebsimin e aciditetit t\u00eb gjakut. P\u00ebrdorimi m\u00eb shum\u00eb i frutave dhe zarzavateve e redukton gjithashtu acidoz\u00ebn metabolike dhe p\u00ebrmir\u00ebson situat\u00ebn klinike t\u00eb k\u00ebtyre pacient\u00ebve. Nga ana tjet\u00ebr, edhe kufizimi i tepruar i proteinave n\u00eb diet\u00eb n\u00eb stadet e p\u00ebrparuara t\u00eb s\u00ebmundjes favorizon kequshqyerjen dhe dob\u00ebsimin e t\u00eb s\u00ebmurit duke ulur rezistenc\u00ebn imune t\u00eb tij e shfaqjen e fenomeneve inflamatore.<\/span><\/p>\n

VINI RE:<\/span> Ky artikull \u00ebsht\u00eb pron\u00eb intelektuale e Shendeti.com.al<\/a><\/span><\/span><\/strong><\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"

Nga Alketa Koroshi, mjeke nefrologe S\u00ebmundjet kronike t\u00eb veshkave p\u00ebrb\u00ebjn\u00eb shumic\u00ebn d\u00ebrmuese t\u00eb s\u00ebmundjeve t\u00eb veshkave n\u00eb p\u00ebrgjith\u00ebsi. Ato jan\u00eb mjaft t\u00eb p\u00ebrhapura n\u00eb t\u00eb gjitha vendet. N\u00eb bot\u00eb jan\u00eb mbi 800 milion\u00eb njer\u00ebz q\u00eb vuajn\u00eb nga s\u00ebmundjet e veshkave. \u00c7do vit vdesin nga s\u00ebmundjet e veshkave afro 950 mij\u00eb njer\u00ebz n\u00eb rruzullin tok\u00ebsor. Jan\u00eb […]<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"author":30,"featured_media":451874,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[],"class_list":["post-451871","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fast-foodi"],"gt_translate_keys":[{"key":"link","format":"url"}],"_links":{"self":[{"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/posts\/451871","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/users\/30"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/comments?post=451871"}],"version-history":[{"count":0,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/posts\/451871\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/media\/451874"}],"wp:attachment":[{"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/media?parent=451871"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/categories?post=451871"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hashtag.al\/index.php\/wp-json\/wp\/v2\/tags?post=451871"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}