Membranous nephropathy

ʻO ka nephropathy membranous kahi maʻi kīhāpai e alakaʻi i nā loli a me nā mumū o nā hanana i loko o ka puʻupaʻa e kōkua i nā ʻōpala kānana a me nā wai. Hiki i ke kuni ke alakaʻi i nā pilikia me ka hana o ka hakuʻala.

Hoʻokumu ʻia ka nephropathy membranous e ka mānoanoa o kahi ʻāpana o ka membrane papa lalo glomerular. ʻO ka membrane papa lalo glomerular kahi ʻāpana o nā puʻupaʻa e kōkua i ka kānana ʻōpala a me nā wai keu mai ke koko. ʻAʻole ʻike ʻia ke kumu kūpono o kēia mānoanoa.

ʻAʻole hana maʻamau ka membrane glomerular mānoanoa. ʻO ka hopena, ua nalo ka nui o nā protein i ka mimi.

ʻO kēia kūlana kekahi o nā kumu maʻamau o nephrotic Syndrome. He pūʻulu kēia o nā ʻōuli e pili pū me ka protein i ka mimi, ke kiʻekiʻe o ka protein protein, nā kiʻekiʻe kolesterol kiʻekiʻe, nā pae triglyceride kiʻekiʻe, a me ka pehu. ʻO ka nephropathy membranous kahi maʻi maʻi kīkī mua, a i ʻole pili ʻia me nā kūlana ʻē aʻe.

ʻO ka mea aʻe e hoʻonui i kou makaʻu no kēia ʻano:

• ʻO nā maʻi maʻi, ʻoiai hoʻi ʻo ka maʻi ʻaʻaʻa a me ka maʻi ʻaʻai
• Hōʻike i nā toxins, me ke gula a me ka mercury
• Nā maʻi, e like me ka maʻi hepa B, malaria, syphilis, a me ka endocarditis
• ʻO nā lāʻau, e laʻa me ka penicillamine, trimethadione, a me nā kalima hoʻoliʻiliʻi ʻili
• ʻO systemic lupus erythematosus, rheumatoid arthritis, maʻi Graves, a me nā maʻi autoimmune ʻē aʻe.

Kū ka maʻi i kēlā me kēia makahiki, akā ʻike pinepine ʻia ma hope o ka makahiki 40.

Hoʻomaka mālie ka hoʻomaka ʻana o nā ʻōuli ma ka manawa, a komo pū paha me:

• Edema (ʻōhū) i kēlā me kēia wahi o ke kino
• Ka luhi
• ʻO ka hua o ka mimi (ma muli o ka nui o nā protein)
• Makemake maikaʻi ʻole
• Urination, nui loa i ka pō
• Kaumaha hoʻonui

Hōʻike kahi hoʻokolohua kino i ka pehu (edema).

Hōʻike paha kahi urinalysis i kahi nui o nā protein i ka mimi. Aia paha kekahi koko i ka mimi.ʻO ke ana filtration glomerular (ka "wikiwiki" kahi e hoʻomaʻemaʻe ai nā puʻupaʻa i ke koko) kokoke pinepine ka maʻamau.

Hana ʻia nā hoʻokolohua ʻē aʻe e ʻike i ke ʻano o ka maikaʻi o ka hana o nā puʻupaʻa a pehea e loli ai ke kino i ka pilikia o ka puʻupaʻa. Pākuʻi ʻia kēia mau mea:

• Albumin - ke koko a me ka mimi
• ʻO nitrogen urea koko (BUN)
• Creatinine - ke koko
• ʻĀina Creatinine
• Panila lipid
• Protein - ke koko a me ka mimi

Hōʻoia kahi biopsy kidney i ke kuhi.

Hiki i nā hōʻike aʻe ke kōkua i ka hoʻoholo ʻana i ke kumu o ka nephropathy membrane.

• ʻO ka hoʻāʻo antinuclear antibodies
• Anati-pālua-strand DNA, inā maikaʻi ka antinuclear antibodies test
• Nā hōʻoia koko e nānā no ka maʻi hepa B, ka maʻi hepitis C, a me ka syphilis
• Nā pae hoʻokō
• Hōʻike ʻo Cryoglobulin

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i nā hōʻailona a hoʻolohi i ka holomua o ka maʻi.

ʻO ka kaohi ʻana i ke kaomi ke ala nui e hoʻopaneʻe ai i ka hōʻino ʻana o ka hakuʻala. ʻO ka pahuhopu ka mālama ʻana i ke kahe o ke koko a i ʻole ma lalo o 130/80 mm Hg.

Pono e mālama ʻia nā pae kiʻekiʻe o ke koko a me nā pae triglyceride e hōʻemi i ka makaʻu no ka atherosclerosis. Eia nō naʻe, ʻaʻole kōkua nui kahi papaʻai momona momona, momona haʻahaʻa i nā poʻe me ka nephropathy membrane.

Hoʻohana ʻia nā lāʻau e mālama ai i ka nephropathy membrane:

• ʻO ka Angiotensin-hoʻololi i ka enzyme (ACE) mea kāohi a me nā angiotensin receptor blockers (ARBs) e hoʻohaʻahaʻa i ke kahe o ke koko
• ʻO Corticosteroids a me nā lāʻau ʻē aʻe e kāohi i ka ʻōnaehana pale
• Nā Laʻau Lapaʻau (nā statins pinepine) e hōʻemi i ka pae kolesterol a me nā triglyceride
• Pila wai (diuretics) e hoʻēmi i ka pehu
• ʻO nā mea lahilahi o ke koko e hōʻemi i ka makaʻu o ke koko i nā akemāmā a me nā wāwae

Kōkua paha ka papaʻai haʻahaʻa-protein. ʻAi ʻia paha kahi papa meaʻai protein-protein (1 gram [gm] o ka protein i kēlā me kēia kilokilo [kg] o ke kaumaha o ke kino i kēlā me kēia lā.

Pono e hoʻololi ʻia ka wikamina D inā lōʻihi ka lōʻihi (mau) nephrotic syndrome a ʻaʻole pane i ka lāʻau.

Hoʻonui kēia maʻi i ka makaʻu o ke koko i nā akemāmā a me nā wāwae. Hoʻopaʻa ʻia nā mea lahilahi koko e pale aku i kēia mau pilikia.

Hoʻololi ka nānā aku, kaukaʻi ʻia i ka nui o ka nalo o ka protein. Aia paha he mau manawa hōʻailona-ʻole a me nā hoʻā ahi i kekahi manawa. I kekahi manawa, hele ke ʻano, me ka ʻole a ʻaʻō ʻole o ka lāʻau.

ʻO ka hapanui o ka poʻe me kēia maʻi e loaʻa ka hōʻino puʻupaʻa a e hoʻomōhala kekahi poʻe i ka maʻi hōʻino hope loa.

ʻO nā pilikia i hopena ʻia mai kēia maʻi ʻo:

• Hoka kōpaʻa paʻa
• Trombosis venous hohonu
• Ka maʻi hōʻino hope loa
• Nā maʻi Nephrotic
• Emperorism pulmonary
• Trombosis aʻa koko

Kāhea i kahi manawa me kāu kahu mālama ola inā:

• Loaʻa iā ʻoe nā ʻōuli o ka nephropathy membrane
• E hele a maikaʻi ʻole kāu mau ʻōuli a mai hele aku
• Hoʻokumu ʻoe i nā ʻōuli hou
• Ua hōʻemi ʻoe i ka puka mimi

ʻO ka mālama ʻana i nā maʻi a me ka hōʻalo ʻana i nā mea e hiki ai ke hoʻoneʻe i ka nephropathy membrane e hōʻemi ai i kou makaʻi.

Membranous glomerulonephritis; Membranous GN; Glomerulonephritis Extramembranous; Glomerulonephritis - membrane; ʻO MGN

• Anatomia hakuʻala

Radhakrishnan J, Appel GB. Nā maʻi Glomerular a me nā syndrome nephrotic. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Maʻi glomerular mua. 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 31.

ʻO Salant DJ, Cattran DC. Membranous nephropathy. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 20.