ʻO ka maʻi ʻaʻai a me ka maʻi kōpaʻa

ʻO ka maʻi maʻi puʻuwai a i ʻole ka hōʻino ʻana o ka puʻupaʻa e hana pinepine ʻia i ka manawa o ka poʻe me ka maʻi kō. Kapa ʻia kēia ʻano maʻi maʻi ʻōpū ma diabetic nephropathy.

Hana ʻia kēlā me kēia puʻukū i nā haneli haneli o nā anakima i kapa ʻia he nephrons. Kuhi kēia mau hale i kou koko, kōkua i ka lawe ʻana i ka ʻōpala mai ke kino, a kaohi i ke kaulike wai.

I ka poʻe me ka maʻi kō, hele a mānoanoa nā nephrons a lilo i welu ma ka manawa. Hoʻomaka e hemo nā nephrons, a hala ka protein (albumin) i ka mimi. Hiki i kēia hōʻino ke hana i mau makahiki ma mua o ka hoʻomaka ʻana o nā ʻōuli o nā maʻi hakuʻala.

ʻOi aku ka pōʻino o ke kīnā inā ʻoe:

• Loaʻa i ke kō kō ʻole
• Ua momona
• Loaʻa i ke koko kiʻekiʻe
• Loaʻa i ka maʻi diabetes type 1 i hoʻomaka ma mua o kou 20 mau makahiki
• Loaʻa i nā lālā o ka ʻohana i loaʻa i ka maʻi diabetes a me nā puʻupaʻa
• Puhi
• He ʻAmelika ʻAmelika, ʻAmelika ʻAmelika, a he ʻAmelika ʻAmelika paha

ʻO ka manawa pinepine, ʻaʻohe ʻōuli ma ke ʻano o ka hōʻino ʻana o ka puʻupaʻa a me ka lohi o ka ʻino. Hiki i nā hōʻino kīwī ke hoʻomaka i 5 a 10 mau makahiki ma mua o ka hoʻomaka ʻana o nā ʻōuli.

ʻO ka poʻe iʻoi aku ka nui a me ka lōʻihi (lōʻihi) maʻi maʻi kīkī e loaʻa i nā ʻōuli e like me:

• Ka luhi i ka hapa nui o ka manawa
• Manaʻo maʻi laulā
• ʻEha poʻo
• Paʻi kuʻi ʻole
• ʻO Nusea a me ka luaʻi
• Makemake maikaʻi ʻole
• ʻO ka pehu ʻana o nā wāwae
• Pokole o ka hanu
• ʻIli ʻili
• Hoʻoulu maʻalahi i nā maʻi

E kauoha kāu kauka olakino i nā hoʻokolohua e ʻike i nā hōʻailona o nā pilikia o ka hakuʻala.

Nānā kahi hōʻike mimi no kahi protein, i kapa ʻia albumin, e kahe ana i ka mimi.

• ʻO ka nui o ka albumin i ka mimi he hōʻailona pinepine ia o ka hōʻino ʻana o ka hakuʻala.
• Kapa ʻia kēia hōʻike he hōʻike microalbuminuria no ka mea ana ana i nā liʻiliʻi o ka albumin.

E nānā pū kāu mea hāʻawi i kāu kaomi koko. Hoʻopilikia ke kahe kiʻekiʻe i kou mau puʻupaʻa, a ʻoi aku ka paʻakikī o ke kahe o ke koko ke loaʻa iā ʻoe ke hōʻino nā puʻupaʻa.

Kauoha ʻia paha kahi biopsy kidney e hōʻoia i ka hōʻoia a nānā paha i nā kumu ʻē aʻe o ka hōʻino ʻana o ka hakuʻala.

Inā loaʻa ʻoe i ka maʻi diabetes, e nānā pū kāu mea hāʻawi i kāu puʻupaʻa ma ka hoʻohana ʻana i nā hoʻokolohua koko aʻe i kēlā me kēia makahiki.

• ʻO nitrogen urea koko (BUN)
• Serum creatinine
• Helu kānana helu glomerular (GFR)

Ke hopu ʻia ka hōʻino ʻana o ka hakuʻala i kona wā mua, hiki ke hoʻolohi ʻia me ka lāʻau. I ka manawa e ʻike ʻia ka nui o nā protein i loko o ka mimi, e pōʻino loa ka hōʻino ʻana o ka hakuʻala.

E hāhai i nā ʻōlelo aʻoaʻo a kāu mea hāʻawi e mālama i kou kūlana mai ka ʻino loa.

E kāohi i kāu kaomi koko

Ke mālama nei i kou kaomi koko ma lalo o ka kaohi (ma lalo o 140/90 mm Hg) ʻo ia kekahi o nā ala maikaʻi loa e hoʻolohi i ka hōʻino ʻana o ka hakuʻala.

• E kauoha aku kāu mea hāʻawi i nā lāʻau kaomi koko e pale aku i kou puʻupaʻa mai ka nui o nā pōʻino inā kiʻekiʻe loa kāu hōʻike microalbumin ma kahi o ʻelua ana.
• Inā kū kou kaomi koko i ka pae maʻamau a loaʻa iā ʻoe ka microalbuminuria, noi ʻia ʻoe e lawe i nā lāʻau kahe o ke koko, akā ua hoʻopaʻapaʻa kēia ʻōlelo paipai i kēia manawa.

KAULAU I KOU MAU KULA KULA KUPUA

Hiki iā ʻoe ke hoʻolohi i ka hōʻino ʻōpala ma ka kaohi ʻana i kāu pae kō kō ma o:

• ʻAi i nā meaʻai olakino
• Ke kiʻi i ka hoʻoikaika kino maʻamau
• Lawe i nā lāʻau oral a i ʻole injection e like me ke kauoha a kāu mea hāʻawi
• Hoʻomaopopo ʻia kekahi mau lāʻau diabetes e pale aku i ka holomua o ka nephropathy diabetic ma mua o nā lāʻau ʻē aʻe. E kamaʻilio i kāu mea hoʻolako e pili ana i nā lāʻau e pono ai nāu.
  
• Ke nānā nei i kāu pae kō kō e like me ke kuhikuhi pinepine ʻia a me ka mālama ʻana i kahi moʻohelu o kāu helu kō kō e ʻike ai i ka hopena o ka ʻai a me nā hana i kāu pae.

Nā ala ʻē aʻe e pale ai i kāu mau keiki

• Hoʻohālikelike ke kala i hoʻohana ʻia i kekahi manawa me ka MRI, CT scan, a i ʻole nā ​​hōʻike kiʻi ʻē aʻe i hiki ke hoʻonui hou i ka hōʻino i kou puʻupaʻa. E haʻi i ka mea hāʻawi e kauoha ana i ka hoʻokolohua he maʻi diabetes kou. E hāhai i nā ʻōkuhi e pili ana i ka inu ʻana i ka wai ma hope o ke kaʻina hana e kāpae i ke kala mai kāu ʻōnaehana.
• Hōʻalo i ka lawe ʻana i ka lāʻau ʻeha NSAID, e like me ka ibuprofen a i ʻole naproxen. E noi i kāu mea hāʻawi inā aia kekahi ʻano lāʻau ʻē aʻe hiki iā ʻoe ke lawe ma kahi. Hiki i nā NSAID ke hōʻino i nā puʻupaʻa, ʻoi aku ke hoʻohana ʻoe iā lākou i kēlā me kēia lā.
• Pono paha kāu mea lawelawe e hoʻokau a hoʻololi paha i nā lāʻau ʻē aʻe i hiki ke hōʻino i kou puʻupaʻa.
• ʻIke i nā hōʻailona o nā maʻi maʻi urinary a mālama koke iā lākou.
• Loaʻa i kahi pae haʻahaʻa o ka wikamina D e hōʻeha i nā maʻi puʻupaʻa. E noi i kāu kauka inā pono ʻoe e lawe i nā mea hoʻonoe vitamin D.

Hiki i nā kumuwaiwai he nui ke kōkua iā ʻoe e ʻike hou e pili ana i ka maʻi kō. Hiki iā ʻoe ke aʻo i nā ala e mālama ai i kāu maʻi puʻupaʻa.

ʻO ka maʻi maʻi diabetic kahi kumu nui o ka maʻi a me ka make i ka poʻe me ka maʻi kō. Hiki iā ia ke alakaʻi i ka pono o ka dialysis a i ʻole ke kuʻi ʻōiwi.

Kāhea i kāu mea hāʻawi inā he maʻi diabetes ʻoe a ʻaʻole i loaʻa kahi hōʻike mimi e nānā ai no ka protein.

Nephropathy diabetic; Nepropathy - diabetic; Glomerulosclerosis diabetic; ʻO ka maʻi ʻo Kimmelstiel-Wilson

• Nā mea kāohi ACE
• ʻAno 2 diabetes - he aha e nīnau aku ai i kāu kauka

• ʻŌnaehana mimi kāne
• ʻO Pancreas a me nā puʻupaʻa
• Nephropathy diabetic

ʻAhahui Diabetes ʻAmelika. 11. ʻO nā pilikia Microvascular a me ka mālama wāwae: nā kūlana o ka mālama olakino ma ka maʻi diabetes-2020. Mālama Diabetes. 2020; 43 (Hōʻawi 1): S135-S151. PMID: 31862754 pubmed.ncbi.nlm.nih.gov/31862754/.

Brownlee M, Aiello LP, Sun JK, et al. Nā pilikia o ka maʻi diabetes. I: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 37.

Tong LL, Adler S, Wanner C. Kāohi a me ka mālama ʻana i nā maʻi maʻi diabetic. I: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Nā Nephrology Haumāna piha. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 31.