Nephritis interstitial
ʻO ka nephritis Interstitial kahi maʻi maʻi ʻōpala kahi e pehu ai nā wahi ma waena o nā tubula puʻupaʻa. Hiki i kēia ke kumu i nā pilikia me ke ʻano o ka hana o kāu mau puʻupaʻa.
Kūlohelohe paha ka nephritis interstitial (huʻihuʻi), a i ʻole he lōʻihi lōʻihi (mau) a ʻinoʻino i ka hala ʻana o ka manawa.
ʻO ke ʻano koʻikoʻi o ka nephritis interstitial pinepine ʻia e nā hopena ʻaoʻao o kekahi mau lāʻau.
Hiki i ka mea aʻe ke kumu i nā nephritis interstitial:
- ʻO ka hopena āpau i kahi lāʻau lapaʻau (nephritis maʻi ākea interstitial).
- Nā maʻi autoimmune, e like me ka antitubular basement membrane disease, maʻi ʻo Kawasaki, Sjögren syndrome, systemic lupus erythematosus, a granulomatosis me polyangiitis.
- Nā maʻi ʻino.
- Hoʻohana lōʻihi o nā lāʻau e like me acetaminophen (Tylenol), aspirin, a me nā lāʻau anti-inflammatory nonsteroidal (NSAIDs). Kapa ʻia kēia he analgesic nephropathy.
- ʻO ka hopena o kekahi mau lāʻau antibiotic e like me penicillin, ampicillin, methicillin, a me nā lāʻau sulfonamide.
- ʻO ka hopena o nā lāʻau ʻē aʻe e like me furosemide, thiazide diuretics, omeprazole, triamterene, a me allopurinol.
- Liʻiliʻi loa ka potassium i kou koko.
- ʻO ka nui loa o ka calcium a i ʻole ka uric acid i kou koko.
Hiki i nā nephritis interstitial ke kumu i nā pilikia puʻuwai koʻikoʻi, e like me ka hōʻeha ʻana o ka haku kōhā. Ma kahi o ka hapalua o nā hihia, e hoʻoliʻiliʻi ka poʻe i ka puka mimi a me nā hōʻailona ʻē aʻe o ka hōʻino ʻole ʻana o ka hakuʻala.
Hiki i nā ʻōuli o kēia ʻano ke komo pū:
- Koko i ka mimi
- Fiva
- Hoʻonui a hoʻemi ʻia paha ka puka mimi
- Hoʻololi ke kūlana noʻonoʻo (hiamoe, huikau, koma)
- Nualea, luaʻi
- Rash
- ʻO ka pehu ʻana o nā wahi o ke kino
- Loaʻa waiwai (mai ka mālama ʻana i ka wai)
E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia:
- Kani nā māmā maʻamau a puʻuwai paha
- Piʻi koko kiʻekiʻe
- Fluid i loko o nā māmā (edema pulmonary)
ʻO nā hōʻike maʻamau e:
- Nā ʻenekini koko arterial
- Ke kemika koko
- Nā pae BUN a me nā mea hana koko
- Helu piha koko
- ʻO Biopsy hakuʻala
- Pākuʻi ultrasound
- Urinalysis
Pili ka mālama ʻana i ke kumu o ka pilikia. ʻO ka pale ʻana i nā lāʻau e alakaʻi ai i kēia ʻano e hōʻoluʻolu koke i nā ʻōuli.
ʻO ka palena ʻana i ka paʻakai a me ka wai i ka papaʻai hiki ke hoʻomaikaʻi i ka pehu a me ke koko kiʻekiʻe. ʻO ke kau palena ʻana i ka protein i loko o ka papaʻai hiki ke kōkua i ke kāohi ʻana i ke kūkulu ʻia ʻana o nā huahana neoneo i loko o ke koko (azotemia), i hiki ai ke alakaʻi ʻia i nā ʻōuli o ka hōʻeha kīwī ʻole.
Inā pono ka dialysis, koi ʻia ia no kahi manawa pōkole wale nō.
ʻO nā lāʻau Corticosteroids a i ʻole ʻoi aku ka ikaika o nā lāʻau anti-inflammatory e like me cyclophosphamide i kekahi manawa.
ʻO ka pinepine, nephritis interstitial kahi maʻi maʻi pōkole. I nā hihia kakaikahi, hiki iā ia ke kumu i ka hōʻino mau loa, me ka ʻole o ke kōkō wā lōʻihi (mau).
Hiki ke ʻoi aku ka ʻino o ka nephritis interstitial ākea a ʻoi aku paha ke alakaʻi i ka pōʻino wā lōʻihi a paʻa mau paha i ka poʻe kahiko.
Hiki i nā metabolic acidosis ke hana no ka hiki ʻole i nā puʻupaʻa ke hemo i ka nui o ka waikawa. Hiki i ka maʻi ke alakaʻi i ke kīkino ʻole a paʻa ʻole paha o ka maʻi kidney.
Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o ka nephritis interstitial.
Inā loaʻa iā ʻoe kahi nephritis interstitial, kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā hōʻailona hou, keu hoʻi inā ʻaʻole ʻoe makaʻala a i ʻole ka emi ʻana o ka mimi.
ʻO ka pinepine, ʻaʻole hiki ke pale ʻia ka maʻi. ʻO ka pale ʻana a hōʻemi ʻana paha i kāu hoʻohana ʻana i nā lāʻau i hiki ke kumu i kēia ʻano hiki ke kōkua i ka hōʻemi ʻana i kou makaʻi. Inā pono, e haʻi aku kāu mea lawelawe iā ʻoe i nā lāʻau e kū a hōʻemi ai paha.
Tubulointerstitial nephritis; Nefitis - interstitial; ʻO ka nephritis interstitial (maʻi maʻi)
- Anatomia hakuʻala
Neilson EG. Nā nephritis tubulointerstitial. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 122.
Perazella MA, Rosner MH. Nā maʻi tubulointerstitial. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 10 o ka lā. Piladelapia, PA: Elsevier; 2020: chap 35.
Tanaka T, Nangaku M. Chronicle interstitial nephritis. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 62.