Reflux nephropathy

ʻO ka Reflux nephropathy kahi kūlana kahi i hōʻino ʻia nā puʻupaʻa e ke kahe hope o ka mimi i loko o ka puʻupaʻa.

Kahe ka mimi mai kēlā me kēia puʻupaʻa ma o nā paipu i kapa ʻia he ureter a i loko o ka pūpū. Ke piha ka ʻōpū, kaomi a hoʻouna i ka mimi ma o ka urethra. ʻAʻole hiki ke kahe i ka mimi i loko o ka ureter ke kaomi nei ka pākeke. Loaʻa i kēlā me kēia ureter kahi kiʻikuhi hoʻokahi ala kahi e komo ai i loko o ka pākū e pale ai i ka mimi mai ke kahe o ka ureter.

Akā i kekahi poʻe, kahe ka mimi i luna i ka puʻupaʻa. Kapa ʻia kēia ʻo vesicoureteral reflux.

I ka hala ʻana o ka manawa, e hōʻeha a wī paha nā puʻupaʻa e kēia reflux. Kapa ʻia kēia ʻo reflux nephropathy.

Hiki i ka reflux ke hana i nā poʻe i pili ʻole ka ureter i ka pākeke a i ʻole e holo pono nā vaʻa. Hānau ʻia paha nā keiki me kēia pilikia a i ʻole he mau kīnā hānau ʻē aʻe o ka ʻōnaehana urinary ke kumu o ka reflux nephropathy.

Hiki i ka nephropathy reflux ke hana me nā kūlana ʻē aʻe e alakaʻi i kahi paʻa o ke kahe mimi, e like me:

• ʻO ka pale i ka puka waho, e like me ka prostate hoʻonui ʻia i nā kāne
• Pōhaku Bladder
• ʻO ka blurder Neurogenic, hiki i nā poʻe me nā sclerosis he nui, nā ʻeha o ke kuamoʻo, ka maʻi diabetes, a me nā ʻōnaehana hopohopo (neurological)

Hiki ke hana i ka nephropathy reflux mai ka pehu ʻana o nā ureter ma hope o ke kuʻi ʻana o ka puʻupaʻa a i ʻole ʻeha i ka ureter.

Nā kumu pilikia no ka reflux nephropathy me:

• Nā pono ʻole o ke kaha urinary
• ʻO ka moʻolelo pilikino a ʻohana paha o ka vesicoureteral reflux
• E hana hou i nā maʻi maʻi urinary

ʻAʻohe o kekahi poʻe i hōʻailona o ka reflux nephropathy. E ʻike ʻia ka pilikia ke hana ʻia nā hoʻokolohua hakuʻala no nā kumu ʻē aʻe.

Inā kū nā ʻōuli, like paha lākou i nā ʻano o:

• Ka hōʻeha kīnā ʻole
• Nā maʻi Nephrotic
• Maʻi ʻaʻai Urinary

ʻIke pinepine ʻia ka nephropathy reflux ke nānā ʻia kahi keiki no nā maʻi maʻi palahalā pinepine. Inā ʻike ʻia ka reflux vesicoureteral, e nānā ʻia paha nā kaikaina o ke keiki, no ka mea hiki i ka reflux ke holo i loko o nā ʻohana.

Hiki ke kiʻekiʻe ke kahe o ke koko, a aia paha he mau hōʻailona a me nā ʻōuli o ka maʻi maʻi lōʻihi (mau).

E hana ʻia nā hoʻokolohua koko a me ka mimi, a hui pū paha me:

• BUN - koko
• Creatinine - ke koko
• ʻO ka hoʻomaʻamaʻa Creatinine - mimi a me ke koko
• Urinalysis a i ʻole 24 mau hola i hoʻopaʻa i ka mimi
• Moʻomeheu mimi

ʻO nā hoʻokolohua kiʻi ʻana i hana ʻia e hoʻopili ʻia:

• Scanner CT ʻōpū
• Ultrasound pūpū
• ʻO ka pyelogram Intravenous (IVP)
• Pākuʻi ultrasound
• ʻO Radionuclide cystogram
• Retrograde pyelogram
• Voiding cystourethrogram

Hoʻokaʻawale ʻia ʻo Vesicoureteral reflux i ʻelima mau kaha ʻokoʻa. Hāʻule pinepine ka reflux maʻalahi a maʻalahi paha i ka papa I a i ʻole II. ʻO ke koʻikoʻi o ka reflux a me ka nui o nā hōʻino i ka puʻuwai e kōkua ai e hoʻoholo i ka mālama ʻana.

Hiki ke mālama ʻia me ka reflux vesicoureteral maʻalahi (i kapa ʻia ʻo reflux mua) me:

• Lawe ʻia nā antibiotic i kēlā me kēia lā e pale i nā maʻi urinary tract
• Ka nānā pono ʻana i ka hana o ka hakuʻala
• Nā moʻomeheu mimi hou
• ʻO ka ultrasound makahiki o nā puʻupaʻa

ʻO ke kaohi ʻana i ke kaomi ke ala nui loa e hōʻemi ai i ka hōʻino ʻana o ka hakuʻala. Kauoha ka mea mālama ola i nā lāʻau e kaohi i ke kahe kiʻekiʻe. Hoʻohana pinepine ʻia nā mea hoʻohālua Angiotensin-hoʻololi i ka enzyme (ACE) a me nā angiotensin receptor blockers (ARBs).

Hoʻohana wale ʻia ke ʻoki lāʻau i nā keiki i pane ʻole i ka lāʻau lapaʻau.

Pono pono ka reflux vesicoureteral ʻoi aku ka nui i ke kahakaha, keu hoʻi i nā keiki e pane ʻole i ka lāʻau lapaʻau. ʻO ke ʻoki kino e hoʻihoʻi i ka ureter i loko o ka pākeke (ureteral reimplantation) hiki iā ia ke hoʻopau i ka reflux nephropathy i kekahi mau hihia.

Pono e pono i ka reflux ʻoi aku ke koʻikoʻi i ke ʻoki hou. Hiki i kēia ʻano ʻoki ke hoʻemi i ka helu a me ke koʻikoʻi o nā maʻi maʻi urinary tract.

Inā pono, e mālama ʻia ka poʻe no ka maʻi maʻi kō.

Hoʻololi nā hopena, e like me ka nui o ka reflux. ʻAʻole e lilo kekahi poʻe me ka nephropathy reflux i ka hana o ke kīhāpai i ka manawa, ʻoiai ua hōʻino ʻia kā lākou puʻupaʻa. Eia nō naʻe, mau paha ka hōʻino ʻana o ka hakuʻala. Inā pili hoʻokahi kīʻaha, e hoʻomau ka hana maʻamau.

Hiki i ka Reflux nephropathy ke kumu i ka holo pono ʻole ʻana o ka hakuʻala i nā keiki a me nā mākua.

ʻO nā pilikia i hopena ʻia mai kēia ʻano a i ʻole kāna mālama ʻana me:

• Blockage o ka ureter ma hope oʻoki kino
• Maʻi maʻi ʻōniʻoniʻo
• Maʻi a hoʻomau hou i nā maʻi maʻi urinary
• Hoʻopau ke kīnā ʻole inā pili nā puʻupaʻa ʻelua (hiki ke holomua i ka hopena o ka maʻi kidney)
• Maʻi kīnā
• Piʻi koko kiʻekiʻe
• Nā maʻi Nephrotic
• Reflux hoʻomau
• Scarring o nā puʻupaʻa

Kāhea i kāu mea hāʻawi inā ʻoe:

• Loaʻa nā hōʻailona o ka reflux nephropathy
• Loaʻa i kekahi mau hōʻailona hou
• Ke hana nei i ka mimi liʻiliʻi ma mua o ka maʻamau

ʻO ka mālama ʻana i nā kūlana e kumu i ka reflux o ka mimi i loko o ka puʻupaʻa e pale i ka reflux nephropathy.

Pyelonephritis atrophic maʻi; Reflux Vesicoureteric; Nepropathy - reflux; ʻO reflux Ureteral

• ʻĀpana mimi wahine
• ʻĀpana mimi kāne
• Voiding cystourethrogram
• ʻO reflux Vesicoureteral

Bakkaloglu SA, Schaefer F. Nā maʻi o ka puʻupaʻa a me ka urinary tract i nā keiki. I: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. ʻO Brenner a me Rector's The Kidney. 10 o ka lā. Piladelapia, PA: Elsevier; 2016: chap 74.

Mathews R, Mattoo TK. ʻO ka reflux vesicoureteral mua a me ka reflux nephropathy. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 61.