ʻAtosis metabolabolic

ʻO ka Metabolic acidosis kahi kūlana i nui loa ka waikawa i nā wai o ke kino.

Hoʻolālā ka metabolic acidosis ke hana ʻia ka nui o ka waikawa i ke kino. Hiki iā ia ke hana ke hiki ʻole i nā puʻupaʻa ke hemo i ka nui o ka waikawa mai ke kino. Aia kekahi mau ʻano o ka metabolic acidosis:

• Hoʻomohala ka diabetic acidosis (i kapa ʻia hoʻi he ketoacidosis diabetic a me DKA) ke kūkulu ʻia nā mea i kapa ʻia he kino ketone (ʻo ia nā acidic) i ka wā o ka maʻi kō.
• Hoʻokumu ʻia ʻo Hyperchloremic acidosis e ka nalo ʻana o ka nui o ka sodium bicarbonate mai ke kino, i hiki ke hana ʻia me ka diarrhea nui.
• ʻO ka maʻi kīnā (uremia, acidal tubular acidosis tubal a i ʻole proximal renal tubular acidosis).
• Losis acidosis.
• Poisoning by aspirin, ethylene glycol (loaʻa i ka antifreeze), a i ʻole methanol.
• Ka make nui loa ʻana.

Nā hopena acidosis lactic mai ka buildup o ka lactic acid. Hana ʻia ka lactic acid i nā hunaola a me nā hunaola ʻulaʻula. Hana ia i ka wā e wāwahi ai ke kino i nā haʻuki kūpona e hoʻohana ai no ka ikehu ke haʻahaʻa nā pae o ka oxygen. Hiki ke kumu ʻia e:

• Kanesa
• Lāʻau make kalapona
• Ke inu nui nei i ka waiʻona
• E hoʻoikaika ikaika ana no ka manawa lōʻihi loa
• Hoka kōpaʻa
• Ke kō koko haʻahaʻa (hypoglycemia)
• Nā lāʻau, e like me salicylates, metformin, anti-retrovirals
• MELAS (kahi maʻi mitochondrial genetical loa e hoʻopili i ka hana ikehu)
• Ka lōʻihi o ka nele o ka oxygen mai ka haʻalulu, ka puʻuwai ʻole, a i ʻole ka anemia koʻikoʻi
• Ka hopu ʻana i nā maʻi

Hoʻokumu ʻia ka hapanui o nā ʻōuli e ka maʻi maʻa a i ʻole ke ʻano e hoʻokumu ana i ka acidosis metabolic. ʻO ka Metosis acidosis ponoʻī ke kumu o ka hanu wikiwiki. Hiki paha ke hana huikau a luhi paha. Hiki i ka metabolic acidosis koʻikoʻi ke alakaʻi i ka weliweli a i ʻole ka make. I kekahi mau hanana, hiki i ka metabolic acidosis ke ʻano akahai, hoʻomau (hoʻomau).

Hiki i kēia mau hoʻāʻo ke kōkua i ka diagnose acidosis. Hiki iā lākou ke hoʻoholo inā he pilikia hanu a kumu paha kahi pilikia metabolic. E komo pū paha nā hoʻāʻo:

• Ke kinoea koko arterial
• Pākuʻi metabolic maʻamau, (kahi hui o nā hoʻokolohua koko e ana i kāu pae sodium a me potassium, hana a me nā hana ʻē aʻe.
• Ketone koko
• Hōʻike ʻakika Lactic
• Nā ketone mimi
• Mimi pH

Pono paha nā hoʻokolohua ʻē aʻe e hoʻoholo i ke kumu o ka acidosis.

Hoʻopaʻa ʻia ka mālama ʻana i ka pilikia olakino e hiki ai i ka acidosis. I kekahi mau hihia, hiki ke hāʻawi ʻia i ka sodium bicarbonate (ka kemika i ka hana kope ʻana e hoʻoliʻiliʻi i ka acidity o ke koko. I ka manawa pinepine, e loaʻa ʻoe i nā wai he nui ma o kou aa koko.

E kau ka maka i ka maʻi kumu e hiki ai ke ʻano.

Hiki i ka acidosis metabolic koʻikoʻi loa ke alakaʻi i ka haʻalulu a i ʻole ka make.

E ʻimi i ke kōkua lapaʻau inā loaʻa iā ʻoe nā ʻōuli o nā maʻi e hiki ke hana i ka metabolic acidosis.

Hiki ke pale ʻia ka ketoacidosis diabetic e ka mālama ʻana i ka maʻi maʻamau ʻo 1.

Acidosis - metabolic

• Ka hana insulina a me ka maʻi kō

Hamm LL, DuBose TD. Nā maʻi o ke kaulike acid-base. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 16.

ʻO Palmer BF. ʻAtosis metabolabolic. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 12.

Seifter JL. Nā maʻi kūmole. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 110.