Membranoproliferative glomerulonephritis

ʻO ka membranoproliferative glomerulonephritis kahi maʻi kīnā e pili ana i ka mumū a me nā loli i nā hunaola kola. Hiki iā ia ke alakaʻi i ka maikaʻi ʻole o ka hakuʻala.

ʻO Glomerulonephritis kahi mumū o ka glomeruli. ʻO ka glomeruli o ka puʻuwai e kōkua i ka kānana ʻōpala a me nā wai mai ke koko e hana i ka mimi.

ʻO ka membranoproliferative glomerulonephritis (MPGN) kahi ʻano o ka glomerulonephritis i hoʻokumu ʻia e kahi pane pale pale ʻole. Kūkulu nā waihona o nā kinikini i kahi ʻāpana o nā puʻupaʻa i kapa ʻia ka membrane papa lalo o glomerular. Kōkua kēia membrane i nā ʻōpala a me nā wai keu o ke koko.

Hoʻopilikia ka poino i kēia membrane i ka hiki i ka hakuʻala e hana i ka mimi maʻamau. ʻAe paha ia e kahe ke koko a me ka protein i ka mimi. Inā lawa ke kahe o ka protein i loko o ka mimi, e kulu paha ka wai mai loko o nā kīʻaha koko i loko o nā kinona o ke kino, e alakaʻi ana i ka pehu (edema). Kūkulu paha nā huahana neoneo Nitrogen i ke koko (azotemia).

ʻO nā ʻano ʻelua o kēia maʻi ʻo MPGN I a me MPGN II.

ʻO ka hapa nui o ka poʻe me ka maʻi i loaʻa ka ʻano I. MPGN II ʻoi aku ka liʻiliʻi o ka maʻamau. ʻOi aku ka maikaʻi o ka wikiwiki ma mua o MPGN I.

ʻO nā kumu o MPGN hiki ke hoʻopili ʻia:

• Nā maʻi Autoimmune (systemic lupus erythematosus, scleroderma, Sjögren syndrome, sarcoidosis)
• Kanesa (leukemia, lymphoma)
• Nā maʻi (hepatitis B, hepatitis C, endocarditis, malaria)

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• Koko i ka mimi
• Nā loli i ke kūlana noʻonoʻo e like me ka hōʻemi o ka makaʻala a i ʻole ka hoʻoliʻiliʻi hoʻoliʻiliʻi
• Mimi ʻōpua
• Mimi ʻeleʻele (uahi, cola, a i ʻole nā ​​kala ʻāhi)
• Hoemi i ka nui o ka mimi
• ʻO ka pehu ʻana o kekahi ʻāpana o ke kino

E nānā ka mea mālama ola iā ʻoe a nīnau e pili ana i kāu mau hōʻailona. ʻIke paha ka mea hāʻawi iā ʻoe he hōʻailona o ka nui o ka wai i loko o ke kino, e like me:

• ʻO ka pupuhi, pinepine i nā wāwae
• Kani nā leo maʻamau ke hoʻolohe nei i kou puʻuwai a me kou mau māmā me kahi stethoscope
• Loaʻa paha iā ʻoe ke koko kiʻekiʻe

Kōkua nā hōʻike aʻe i ka hōʻoia ʻana i ka hōʻailona.

• BUN a me ka hoʻāʻo ʻana o ke koko creatinine
• Nā pae hoʻokō koko
• Urinalysis
• Pīmī protein
• ʻO ka biopsy hakuʻala (e hōʻoia i ka membranoproliferative GN I a i ʻole II)

Kaukaʻi hilinaʻi nui ʻia ma nā ʻōuli. ʻO nā pahuhopu o ka mālama ʻana e hōʻemi i nā ʻōuli, pale i nā pilikia, a hoʻolohi i ka holomua o ka maʻi.

Pono paha ʻoe e loli i ka papaʻai. Pākuʻi paha kēia i ka palena ʻana i ka sodium, nā wai, a i ʻole ka protein e kōkua i ke kaohi ʻana i ke koko kiʻekiʻe, ka pehu ʻana, a me ke kūkulu ʻana o nā huahana neoneo i loko o ke koko.

ʻO nā lāʻau i kauoha ʻia e hoʻopili ʻia:

• ʻO nā lāʻau kaomi koko
• Dipyridamole, me ka aspirin me ka ʻole
• ʻO Diuretics
• Nā lāʻau e kāohi i ka ʻōnaehana pale, e like me cyclophosphamide
• ʻO Steroids

ʻOi aku ka maikaʻi o ka mālama ʻana i nā keiki ma mua o ka poʻe mākua. Dialysis a i ʻole hakuʻala transplant paha e pono ai no ka mālama ʻana i ka hakuʻala kō ʻole.

Lōʻihi ka hōʻino ʻana o ka maʻi a hopena i nā hopena maʻi ʻole.

ʻO ka hapalua o ka poʻe me kēia ʻano e hoʻomōhala i ka wā lōʻihi (maʻi mau) i loko o 10 mau makahiki. ʻOi aku paha kēia i ka poʻe i loaʻa ka nui o nā protein i loko o kā lākou mimi.

ʻO nā pilikia i hopena ʻia mai kēia maʻi ʻo:

• ʻO ka maʻi nephritic koʻikoʻi
• Hoka kōpaʻa koʻikoʻi
• Maʻi maʻi ʻōniʻoniʻo

Kāhea i kahi manawa me kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o kēia maʻi
• E hele a maikaʻi ʻole kāu mau ʻōuli a mai hele aku
• Hoʻolālā ʻoe i nā ʻōuli hou, me ka hoʻemi ʻia o ka mimi

ʻO ka pale ʻana i nā maʻi e like me ka hepatitis a i ʻole ka mālama ʻana i nā maʻi e like me ka lupus hiki ke pale aku iā MPGN.

Membranoproliferative GN I; Membranoproliferative GN II; Mesangiocapillary glomerulonephritis; Membranoproliferative glomerulonephritis; Lobular GN; Glomerulonephritis - membranoproliferative; MPGN ʻano I; MPGN ʻano II

• Anatomia hakuʻala

Roberts ISD. Nā maʻi kīwī. I: Cross SS, ed. Underwood's Pathology: Kahi hoʻokokoke. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 21.

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.

Sethi S, De Vriese AS, Fervenza FC. ʻO ka glomerulonephritis membranoproliferative a me ka glomerulonephritis cryoglobulinemic. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 21.