Maʻi maʻi ʻōniʻoniʻo

ʻO ka maʻi maʻi puʻuwai maʻi ka lohi o ka nalo ʻana o ka hana hakuʻala ma luna o ka manawa. ʻO ka hana nui o nā puʻupaʻa e wehe i nā ʻōpala a me ka nui o ka wai mai ke kino.

ʻOi aku ka maikaʻi o ka maʻi maʻi kō (CKD) ma mua o nā mahina a i ʻole nā ​​makahiki. ʻAʻole paha ʻoe e ʻike i kekahi ʻōuli no kekahi manawa. Lohi paha ka nalo o ka hana i ʻole ʻoe e loaʻa nā hōʻailona a hiki i ka pau ʻana o kāu mau puʻupaʻa i ka hana.

Kāhea ʻia ka pae hope loa o CKD i ka maʻi hōʻino hope loa (ESRD). I kēia wā, ʻaʻole hiki i nā puʻupaʻa ke hoʻopau i nā ʻōpala a me nā wai keu mai ke kino. I kēia manawa, pono ʻoe i ka dialysis a i ʻole ke kuʻi ʻōiwi.

ʻO ka maʻi diabetes a me ke koko kiʻekiʻe nā kumu maʻamau a 2 no ka nui o nā hihia.

Hiki i nā maʻi a me nā kūlana ʻē aʻe ke hōʻino i nā puʻupaʻa, me:

• Nā maʻi Autoimmune (e like me systemic lupus erythematosus a me scleroderma)
• Nā kīnā hānau o nā puʻupaʻa (e like me ka maʻi polycystic kidney)
• Kekahi mau kemika ʻino
• Ka hōʻeha i ka puʻupaʻa
• Nā pōhaku hakuʻala a me ka maʻi
• Nā pilikia me nā aʻa e hānai ana i nā puʻupaʻa
• ʻO kekahi mau lāʻau, e like me ka ʻeha a me nā lāʻau ʻaʻai
• Kahe hope o ka mimi i loko o nā puʻupaʻa (reflux nephropathy)

Alakaʻi ʻo CKD i ke kūkulu ʻia ʻana o ka wai a me nā huahana neoneo i ke kino. Hoʻopili kēia ʻano i ka nui o nā ʻōnaehana a me nā hana, e like me:

• Piʻi koko kiʻekiʻe
• Helu hapa haʻahaʻa o ke koko
• Wikamina D a me ka olakino iwi

ʻO nā ʻōuli mua o CKD ka mea like me nā maʻi ʻē aʻe. ʻO kēia mau hōʻailona ke hōʻailona wale nō o kahi pilikia i nā wā mua.

Pākuʻi ʻia paha nā ʻōuli:

• Nānā ʻai
• Manaʻo nui a luhi hoʻi
• Poʻo poʻo poʻo
• Mākaʻu (pruritus) a me ka ʻili maloʻo
• Nusea
• ʻO ka hōʻemi kaumaha me ka hoʻāʻo ʻole e lilo i ka kaumaha

Nā ʻōuli e hiki ke hana ʻia i ka wā i ʻoi aku ka maikaʻi o ka hana o ka hakuʻala.

• ʻEleʻeleʻeleʻele a lahilahi paha
• ʻEha iwi
• Hiamoe a pilikia paha e noʻonoʻo ana
• Pōpō a ʻōhū paha i nā lima a me nā wāwae
• Pākuʻi i ka mākala a i ʻole ke ʻūlū
• ʻAʻala hanu
• ʻŪpī maʻalahi, a i ʻole ke koko i ka pahu
• Make wai nui loa
• Nā hiccup pinepine
• Nā pilikia me ka hana moekolohe
• Kū ka manawa menstrtrual (amenorrhea)
• Pokole o ka hanu
• Pilikia hiamoe
• ʻO ka luaʻi

ʻO ka hapa nui o ka poʻe e loaʻa i ke koko kiʻekiʻe ma nā pae a pau o CKD. I ka wā o kahi hoʻokolohua, lohe paha kāu mea mālama ola i nā puʻuwai abnormal a i ʻole nā ​​kani i loko o kou umauma. Hiki paha iā ʻoe ke hōʻailona o ka hōʻino nerve i ka wā o ka hoʻokolohua ʻōnaehana.

Hōʻike paha kahi urinalysis i ka protein a i ʻole nā ​​hoʻololi ʻē aʻe i kāu mimi. Hōʻike ʻia kēia mau hoʻololi i 6 a 10 mau mahina a ʻoi paha ma mua o ka ʻike ʻia ʻana o nā ʻōuli.

ʻO nā hoʻāʻo e nānā i ka maikaʻi o ka hana ʻana o nā puʻupaʻa:

• ʻĀina Creatinine
• Nā pae Creatinine
• ʻO nitrogen urea koko (BUN)

Hoʻololi ʻo CKD i nā hopena o kekahi mau hoʻokolohua ʻē aʻe. Pono ʻoe e loaʻa i nā hōʻike aʻe e like me ka pinepine i kēlā me kēia 2 a 3 mau mahina ke hele a hewa ka maʻi kōpū.

• Albumin
• Kalipuna
• Kolesterol
• Helu piha koko (CBC)
• Nā uila
• Makanekiuma
• Phosphorous
• Pāpaʻakai
• Sodoma

Nā hoʻokolohua ʻē aʻe e hana ʻia e nānā no ke kumu a i ʻole ke ʻano o nā maʻi puʻupaʻa e komo pū ana:

• CT scan o ka ʻōpū
• MRI o ka ʻōpū
• Ultrasound o ka ʻōpū
• ʻO Biopsy hakuʻala
• Mīkini ʻiʻo
• Pākuʻi ultrasound

Hoʻololi paha kēia maʻi i nā hopena o nā hōʻike aʻe:

• Erythropoietin
• ʻO ka hormone Parathyroid (PTH)
• Hōʻike ʻāpana iwi
• ʻO ka pae Vitamin D

ʻO ke kaohi kaomi koko e hoʻolohi hou i ka hōʻino ʻana o ka hakuʻala.

• ʻO ka Angiotensin-hoʻololi i ka enzyme (ACE) mea kāohi a i ʻole nā ​​angiotensin receptor blockers (ARB) i hoʻohana pinepine ʻia.
• ʻO ka pahuhopu ka mālama ʻana i ke kahe o ke koko a i ʻole ma lalo o 130/80 mm Hg.

Hiki i nā loli nohona ke kōkua i ka pale ʻana i nā puʻupaʻa, a pale i ka maʻi puʻuwai a me ka hahau ʻana, e like me:

• MAI Puhi.
• E ʻai i nā meaʻai i momona a momona ka momona.
• E kiʻi i ka hoʻoikaika kino maʻamau (e kamaʻilio me kāu kauka a kahu hānai paha ma mua o ka hoʻomaka ʻana o ka hoʻoikaika kino).
• Lawe i nā lāʻau e hoʻohaʻahaʻa i kāu kolesterol, inā pono.
• E mālama i kāu kō kō.
• Hōʻalo i ka ʻai ʻana i ka paʻakai a i ka potassium paha.

E kamaʻilio mau i kāu kauka kōkō ma mua o ka lawe ʻana i ka lāʻau i ka counter. Hoʻopili kēia i nā huaora, nā mea kanu a me nā mea hoʻohui. E ʻike pono nā poʻe lawelawe āu e kipa aku ai he CKD kāu. Hiki i nā mālama ʻē aʻe ke:

• Kapa ʻia nā lāʻau lapaʻau i nā mea paʻa phosphate, i mea e pale aku ai i nā pae phosphorous kiʻekiʻe
• ʻO ka hao keu i ka papaʻai, nā pila hao, hao i hāʻawi ʻia ma o ka aa (iron intravenous iron) nā pana kūikawā o kahi lāʻau i kapa ʻia ʻo erythropoietin, a me nā transfusions o ke koko e mālama ai i ka anemia
• ʻO ke calcium a me ka huaʻa D keu (e kamaʻilio mau i kāu mea hāʻawi ma mua o ka lawe ʻana)

Hāʻawi paha kāu mea lawelawe iā ʻoe e hāhai i kahi papaʻai kūikawā no CKD.

• Ka palena ʻana i nā wai
• ʻOi aku ka liʻiliʻi o ka protein
• Kaohi ʻana i ka phosphorous a me nā electrolytes ʻē aʻe
• Loaʻa ka lawa ʻana o nā calori e pale ai i ka pohō kaumaha

Pono nā kānaka āpau me CKD e hōʻano hou i kēia mau lāʻau āpau:

• Hepatitis A lāʻau āpau
• ʻO ka lāʻau hoʻomaʻi Hepatitis B
• Puukū flu
• ʻO ka lāʻau lapaʻau Ponia (PPV)

Pōmaikaʻi kekahi poʻe mai ka lawe ʻana i kahi hui kākoʻo maʻi maʻi kōkō.

ʻAʻole ʻike ʻia ka poʻe he nui me ka CKD a hiki i ka nalowale ʻana o ka hapa nui o kā lākou hana hakuʻala.

ʻAʻohe mea ola no CKD. Inā ʻino ia iā ESRD, a pehea ka wikiwiki, hilinaʻi ʻia ma:

• Ke kumu o ka hōʻino ʻana o ka hakuʻala
• Pehea kou mālama pono ʻana iā ʻoe iho

ʻO ke kīnā ʻole ʻo ke kīhāpai ka pae hope loa o CKD. ʻO kēia ke hiki ʻole i kou puʻupaʻa ke kākoʻo hou aku i nā pono o ko mākou kino.

E kūkākūkā kāu mea lawelawe me ka dialysis ma mua ou e pono ai. Lawe ka Dialysis i nā ʻōpala mai kou koko ke hiki ʻole i kou puʻupaʻa ke hana hou i kā lākou hana.

I ka hapanui o nā hihia, e hele ʻoe i ka dialysis ke loaʻa iā ʻoe he 10 a 15% wale nō o kāu hana hakuʻala i koe.

ʻOiai ʻo ka poʻe e kali nei no kahi transplan kidney e pono paha i ka dialysis ke kali nei.

Komo pū nā pilikia:

• Anemia
• Kahe mai ka ʻōpū a i ʻole ka ʻōpū
• Iwi, ami, a ʻeha puʻupuʻu
• Nā loli i ke kō kō
• Poino i nā aʻalolo o nā wāwae a me nā lima (peripheral neuropathy)
• Dementia
• Hoʻopili ka wai a puni nā māmā (pleural effusion)
• Nā pilikia o ka naʻau a me ke koko
• Nā pae phosphorous kiʻekiʻe
• Nā pae potassium kiʻekiʻe
• Hyperparathyroidism
• Hoʻonui i ka pilikia o nā maʻi
• Ka hōʻino ʻana o ke ake a i ʻole kūleʻa ʻole
• Kaʻai pono ʻole
• Hewa a me ka infertility
• Ka hopu ʻana i nā maʻi
• Pehu (edema)
• Nāwaliwali o nā iwi a hoʻonui i ka maka o nā haki

ʻO ka mālama ʻana i ke ʻano e hoʻopilikia nei i ka pilikia e kōkua ke pale aku a hoʻopaneʻe paha iā CKD. Pono ka poʻe i loaʻa i ka maʻi diabetes e kāohi i ko lākou kō kō a me nā kiʻekiʻe o ke koko a pono ʻole e puhi.

Hewa ʻiʻo - maʻi mau; Hewa kō ʻole - maʻi mau; Ka lawa kūpono ʻole o ke kīnā ʻole; ʻOle kīnā ʻole; Hoka kōpaʻa paʻa

• Anatomia hakuʻala
• ʻO Kidney - ke kahe o ke koko a me ka mimi
• ʻO Glomerulus a me nephron

ʻO Christov M, ʻo Sprague SM. Maʻi maʻi ʻōniʻoniʻo - maʻi iwi iwi. 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 53.

Grams ME, McDonald SP. Epidemiology o ka maʻi puʻuwai maʻi a me ka dialysis. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 77.

Taal MW. Ka hoʻolaʻa ʻana a me ka hoʻokele ʻana i nā maʻi puʻupuʻu mau. 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 59.