Nā maʻi Nephrotic

ʻO ka nephrotic syndrome kahi hui o nā ʻōuli e pili pū me ka protein i ka mimi, nā pae protein o ke koko haʻahaʻa i ke koko, nā kiʻekiʻe kolesterol kiʻekiʻe, nā pae triglyceride kiʻekiʻe, hoʻonui i ka makaʻu o ke kō, a me ka ʻōhū.

Hoʻokumu ʻia ka maʻi nephrotic e nā maʻi like ʻole e hōʻino i nā puʻupaʻa. ʻO kēia ʻino e alakaʻi i ka hoʻokuʻu ʻana o ka protein i ka mimi.

ʻO ke kumu maʻamau i nā keiki ka maʻi loli liʻiliʻi. ʻO ka membranous glomerulonephritis ka mea maʻamau i nā mākua. I nā maʻi ʻelua, ua hōʻino ʻia ka glomeruli i nā puʻupaʻa. ʻO Glomeruli nā hale e kōkua i ka kānana ʻōpala a me nā wai.

Hiki i kēia ʻano ke hana mai:

• Kanesa
• Nā maʻi e like me ka maʻi diabetes, systemic lupus erythematosus, myeloma maha, a me amyloidosis
• Nā maʻi genetic
• Nā maʻi pale maʻi
• Nā maʻi āpau (e like me ka ʻālina strep, hepatitis, a i ʻole mononucleosis)
• Hoʻohana o kekahi mau lāʻau

Hiki iā ia ke hana me nā maʻi ʻōpū e like me:

• ʻO glomerulosclerosis ka nānā ʻana a me ka māhele
• Glomerulonephritis
• ʻO Mesangiocapillary glomerulonephritis

Hiki i ka nephrotic maʻi ke hoʻopili i nā hui makahiki āpau. I nā keiki, he mea maʻa mau ia ma waena o nā makahiki 2 a me 6. ʻOi pinepine pinepine kēia maʻi i nā kāne ma mua o nā wahine.

ʻO ka pehu (edema) ka hōʻailona maʻamau. Hiki paha:

• I ka maka a puni nā maka (ʻōhū o ka maka)
• I nā lima a me nā wāwae, ʻo ka wāwae hoʻi a me nā kuʻekuʻe wāwae
• I loko o ka ʻōpū wahi (ʻōpū ʻōpū)

ʻO nā ʻōuli ʻē aʻe e like me:

• ʻEha a ʻeha hoʻi o ka ʻili
• ʻO ka helehelena hua o ka mimi
• Makemake maikaʻi ʻole
• Loaʻa kaupaona (ʻike ʻole ʻia) mai ka paʻa ʻana o ka wai
• Ka hopu ʻana i nā maʻi

E hana ka mea mālama ola i kahi hoʻokolohua kino. E hana ʻia nā hoʻokolohua Laboratory e ʻike i ke ʻano o ka hana o nā puʻupaʻa. Pākuʻi ʻia lākou:

• Hōʻike koko Albumin
• Nā hoʻāʻo kemika koko, e like me ka paneli metaboliko maʻamau a i ʻole ka panel metabolic ākea
• ʻO nitrogen urea koko (BUN)
• Creatinine - hoʻāʻo koko
• ʻO ka hoʻomaʻemaʻe Creatinine - hoʻāʻo mimi
• Urinalysis

Aia mau nā momona i ka mimi. Hiki ke kiʻekiʻe ke koko a me nā pae triglyceride.

Pono paha kahi biopsy kidney e ʻike i ke kumu o ka maʻi.

ʻO nā hoʻāʻo e kāpae i nā kumu like ʻole e hoʻopili i kēia mau mea:

• Antinuclear antibody
• ʻO Cryoglobulins
• Nā pae hoʻokō
• ʻO ka hoʻāʻo ahonui Glucose
• Hepatitis B a me nā mea ʻino C
• Hōʻike HIV
• ʻLelo Rheumatoid
• ʻO ka electrophoresis protein protein (SPEP)
• Serology Syphilis
• Uila mimi protein electrophoresis (UPEP)

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

• ʻO ka pae Vitamin D
• ʻO ka hao serum
• Holo ka mimi

ʻO nā pahuhopu o ka mālama ʻana e hōʻoluʻolu i nā ʻōuli, pale i nā pilikia, a hoʻopaneʻe i ka hōʻino ʻana o ka hakuʻala. No ka mālama ʻana i ka maʻi nephrotic, pono e mālama ʻia ka maʻi nāna e hoʻopuka nei. Pono ʻoe e mālama i ke ola.

Hiki i nā mālama ke hoʻopili i kekahi o kēia mau mea:

• Ka mālama ʻana i ke kahe o ke koko a i ʻole ma lalo o 130/80 mm Hg e hoʻopaneʻe ai i ka hōʻino ʻana o ka hakuʻala. ʻO ka Angiotensin-hoʻololi i ka enzyme (ACE) mea kāohi a i ʻole nā ​​angiotensin receptor blockers (ARBs) nā lāʻau i hoʻohana pinepine ʻia. Hiki i nā mea kāohi ACE a me nā ARB ke kōkua pū i ka hoʻoliʻiliʻi i ka nui o nā protein i lilo i ka mimi.
• ʻO Corticosteroids a me nā lāʻau ʻē aʻe e kāohi a mālie paha i ka ʻōnaehana pale.
• ʻO ka mālama ʻana i ke kolesterol kiʻekiʻe e hōʻemi ai i ka makaʻi no ka pilikia o ka naʻau a me ke kīʻaha koko - ʻAʻohe lawa kaʻai momona momona, haʻahaʻa-koloka no ka poʻe me ka maʻi nephrotic. ʻO nā lāʻau e hōʻemi ai i ka cholesterol a me nā triglycerides (maʻa mau statins) e pono ai.
• Hiki ke kōkua i kahi papa sodium liʻiliʻi me ka pehu ʻana i nā lima a me nā wāwae. Pēlā pū nā pila wai (diuretics) i kēia pilikia.
• Kōkua paha ka papaʻai haʻahaʻa-protein. Kuhi paha kāu mea hāʻawi i kahi papa waena protein-protein (1 gram o ka protein i kēlā me kēia kilokilo o ke kaumaha o ke kino i kēlā me kēia lā).
• Lawe i nā mea hoʻohui wikamina D inā lōʻihi lōʻihi ka nephrotic syndrome a ʻaʻole pane i ka lāʻau.
• Lawe i nā lāʻau lahilahi o ke koko e mālama a pale aku ai i ke koko.

Kūleʻa ka hopena. Ola kekahi poʻe mai ke ʻano. Hoʻolālā kekahi i nā maʻi maʻi lōʻihi lōʻihi a pono i ka dialysis a i ka hopena he transplant kidney.

ʻO nā pilikia olakino i hopena ʻia mai ka nephrotic syndrome me:

• Hewa kōwi koʻikoʻi
• ʻO ka paʻakikī o nā aʻa a me nā maʻi puʻuwai e pili ana
• Maʻi maʻi ʻōniʻoniʻo
• ʻO ka nui o ka wai, ka maikaʻi ʻole o ka puʻuwai, ka paʻa ʻana o ka wai i nā akemāmā
• Nā maʻi āpau, me ka maʻi pneumococcal pneumonia
• Kaʻai pono ʻole
• Trombosis aʻa koko

Kāhea i kāu mea hāʻawi inā:

• Hoʻokumu ʻoe a ʻo kāu keiki paha i nā ʻōuli o nephrotic Syndrome, me ka pehu ʻana i ka maka, ʻōpū, a i ʻole nā ​​lima a me nā wāwae, a i ʻole nā ​​ʻeha ʻili
• Mālama ʻia ʻoe a ʻo kāu keiki paha no ka maʻi nephrotic, akā ʻaʻole hoʻomaikaʻi nā ʻōuli
• Kūkulu nā ʻōuli hou, e laʻa me ka uha, hoʻemi i ka puka mimi, hōʻoluʻolu ʻole me ka mimiki, ke kuni, ke poʻo ʻeha loa

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) inā loaʻa ʻoe i ka hopu ʻana.

ʻO ka mālama ʻana i nā kūlana i hiki ke kumu i ka maʻi nephrotic e kōkua i ka pale ʻana i ka maʻi.

Nefrosis

• Anatomia hakuʻala

ʻO Erkan E. Nephrotic maʻi maʻi. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 545.

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.