ʻO Distal renal tubular acidosis

ʻO Distal renal tubular acidosis kahi maʻi ia e hiki ke lawe ʻole nā ​​puʻupaʻa i nā waikawa mai ke koko i ka mimi. A ʻo kahi hopena, nui nā waikawa i koe i ke koko (i kapa ʻia ʻo acidosis).

Ke hana nei ke kino i kāna mau hana maʻamau, hana ia i ka waikawa. Inā ʻaʻole lawe ʻia a hoʻokaʻawale ʻia kēia waikawa, e lilo ke koko i acidic. Hiki i kēia ke alakaʻi i nā kaulike electrolyte i ke koko. Hiki iā ia ke kumu i nā pilikia me ka hana maʻamau o kekahi mau hunaola.

Kōkua nā puʻupaʻa i ka mālama ʻana i ka pae o ke kino ma ka hemo ʻana i ka waikawa mai ke koko a hoʻokuʻu aku iā ia i ka mimi.

Hoʻokumu ʻia ʻo Distal renal tubular acidosis (ʻano I RTA) e kahi kīnā i loko o nā puʻupaʻa pūpū e hoʻokumu i ka waikawa i loko o ke koko.

Hoʻokumu ʻia ka ʻano I RTA e nā ʻano ʻano like ʻole, me:

• ʻO Amyloidosis, kahi kūkulu o nā protein pono ʻole, i kapa ʻia ʻo amyloid, i loko o nā aʻa a me nā meaola
• ʻO ka maʻi Fabry, kahi kūkulu kino ʻole i ke kino o kekahi ʻano momona o ka momona
• ʻO ke kiʻekiʻe o ka calcium i loko o ke koko
• ʻO ka maʻi maʻi maʻi, nā ʻulaʻula o ke koko e hoʻohālikelike ʻia e like me kahi diski e lawe ai i ka pahi kākela a i ʻole ke ʻano crescent
• ʻO Sjögren Syndrome, kahi maʻi autoimmune kahi e luku ʻia ai nā glands e hana ai i ka waimaka a me ka luha
• ʻO systemic lupus erythematosus, kahi maʻi autoimmune kahi e kuhi hewa ai ka ʻōnaehana pale kino i nā mea olakino maikaʻi.
• ʻO ka maʻi ʻo Wilson, kahi maʻi hoʻoilina i nui ai ke keleawe i loko o nā kino o ke kino
• Hoʻohana o kekahi mau lāʻau, e like me amphotericin B, lithium, a me nā analgesics

Nā ʻōuli o ka distal renal tubular acidosis e komo pū kekahi o kēia mau mea:

• Huikau a hoʻoliʻiliʻi paha ka makaʻala
• Ka luhi
• Ka ulu maikaʻi ʻole o nā keiki
• Hoʻonui ka nui o ka hanu ʻana
• Pohaku hakuʻala
• Nā Nefrocalcinosis (nui ka calcium i waiho ʻia i nā puʻupaʻa)
• Osteomalacia (palupalu o nā iwi)
• Nāwaliwali ka ʻiʻo

Hiki i nā ʻōuli ʻē aʻe ke:

• ʻEha iwi
• Hoʻoemi i ka puka mimi
• Hoʻonui i ka helu o ka puʻuwai a i ʻole ka puʻuwai kūlike ʻole
• Pākuʻi kaʻiʻo
• ʻEha ma ka hope, ʻaoʻao, a i ʻole ka ʻōpū
• Nā hana kūpono ʻole o ka iwi

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona.

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• Ke kinoea koko arterial
• Ke kemika koko
• Mimi pH
• Hōʻike hoʻowahāwahā kūmole
• Hōʻike hoʻāʻo Bicarbonate infusion
• Urinalysis

Hiki ke ʻike ʻia nā waihona kalipuna ma nā puʻupaʻa a me nā pōhaku kōkō ma:

• Nā kukuna X
• Kukuna ultrasound
• CT scan

ʻO ka pahuhopu e hoʻihoʻi i ke kiʻekiʻe o ka waikawa maʻamau a me ke kaulike electrolyte i ke kino. E kōkua kēia i ka hoʻoponopono ʻana i nā maʻi iwi a hoʻēmi i ka buildup calcium i loko o nā puʻupaʻa (nephrocalcinosis) a me nā pōhaku ʻiʻo.

ʻO ke kumu kumu o ka distal renal tubular acidosis e hoʻoponopono ʻia inā hiki ke ʻike ʻia.

ʻO nā lāʻau e kuhikuhi ʻia ai e komo pū me ka potassium citrate, sodium bicarbonate, a me thiazide diuretics. ʻO kēia nā lāʻau alkaline e kōkua i ka hoʻoponopono i ke ʻano acidic o ke kino. Hiki i ka Sodium bicarbonate ke hoʻoponopono i ka nalo ʻana o ka potassium a me ka puna.

Pono e mālama ʻia ka maʻi e hōʻemi ai i nā hopena a me nā pilikia, hiki ke hoʻomau a hoʻoweliweli paha i ke ola. ʻOi aku ka maikaʻi o ka hapa nui o nā hihia me ka lāʻau.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o ka distal renal tubular acidosis.

E kiʻi koke i ke kōkua lapaʻau inā hoʻomohala ʻoe i nā ʻōuli pilikia e like me:

• Hoemi i ka ʻike
• Ka hopu ʻana i nā maʻi
• Hoʻoemi nui i ka makaʻala a i ʻole ka hoʻonohonoho ʻana

ʻAʻohe pale no kēia maʻi.

Renal tubular acidosis - distal; ʻO ka Renal tubular acidosis ʻano I; ʻAno I RTA; RTA - distal; RTA kahiko

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

Bushinsky DA. Pohaku hakuʻala. I: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 32.

ʻO Dixon BP. Acidosis tubular hōʻino. 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 547.

Seifter JL. Nā maʻi kūmole. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 110.