Hewa kōwi koʻikoʻi

ʻO ka hōʻino kīwī koʻikoʻi ka wikiwiki (ma lalo o 2 mau lā) ka nalowale o kāu mau puʻupaʻa hiki ke hemo i nā ʻōpala a kōkua i ke kaulike i nā wai a me nā electrolytes i kou kino.

Nui nā kumu kūpono o ka hōʻino ʻana o ka hakuʻala. Pākuʻi ʻia lākou:

• Huikau tubros nekrosis (ATN; poino i nā tubule o nā puʻupaʻa)
• Maʻi maʻi maʻi autoimmune
• Koko koko mai ka kolesterol (kolamu emboli)
• Hoemi i ke kahe o ke koko ma muli o ke kahena haʻahaʻa loa, hiki ke hopena i ke ahi, make wai, hemorrhage, ʻeha, septic shock, maʻi nui, a ʻokiʻoki paha.
• Nā maʻi e kumu ai ka hoʻopili ʻana i loko o nā kīʻaha koko koko
• Nā maʻi i hōʻeha pono i ka puʻupaʻa, e like me ka pyelonephritis huʻupuʻu a i ʻole septicemia
• Nā pilikia o ka hāpai ʻana, e like me ka abruption o ka placenta a i ʻole ka placenta previa
• Ka paʻa ʻana o ka mimi
• Nā lāʻau lapaʻau kīnā ʻole e like me ka cocaine a me ka heroine
• ʻO nā lāʻau lapaʻau e laʻa me nā lāʻau anti-inflammatory non-steroidal (NSAIDs), kekahi mau lāʻau antibiotic a me nā lāʻau kaomi koko, hoʻokaʻawale intravenous (dye), kekahi maʻi ʻaʻai a me nā lāʻau HIV

Nā hōʻailona o ka hōʻino kīwī ʻole e hoʻopili i kekahi o kēia:

• Nā noho koko
• ʻAno hanu a me ka ʻono metallic i ka waha
• Māmā maʻalahi
• Nā hoʻololi i ke kūlana noʻonoʻo a i ʻole ʻano
• Hoʻoemi i ka makemake
• Hoʻoemi i ka sensation, keu hoʻi i nā lima a me nā wāwae
• Ka luhi a hoʻoneʻe paha i nā neʻe lohi
• ʻO kaʻeha flank (ma waena o nā iwi ʻaoʻao a me nā pūhaka)
• Weliweli lima
• Ohumu puuwai
• Piʻi koko kiʻekiʻe
• ʻO Nusea a i ʻole ka luaʻi, hiki ke hala i mau lā
• Nā Nosebleeds
• Hiccup paʻa mau
• Kahe lōʻihi ʻana
• Ka hopu ʻana i nā maʻi
• Pokole o ka hanu
• ʻO ka pehu ma muli o ke kino e mālama nei i ka wai (ʻike ʻia i nā wāwae, nā kuʻekuʻe wāwae, a me nā wāwae)
• Hoʻololi ka urination, e like me ka liʻiliʻi a ʻaʻohe mimi paha, ka nui o ka urination i ka pō, a i ʻole ka mimi e kū paʻa loa

E nānā ka mea mālama ola iā ʻoe.

Nā hoʻāʻo e nānā i ke ʻano o ka maikaʻi o ka hana o kāu mau puʻupaʻa:

• BUNU
• ʻĀina Creatinine
• Serum creatinine
• Pāhare potassium
• Urinalysis

Hana ʻia nā hoʻokolohua koko ʻē aʻe e ʻike i ke kumu kumu o ka holo pono ʻole ʻana o ka hakuʻala.

ʻO kahi kīʻaha a i ʻole ka ultrasound ʻōpū ka hoʻāʻo i makemake ʻia no ke kuhi ʻana i kahi poloka ma ke kahe urinary. Hiki i ka X-ray, CT scan, a i ʻole MRI o ka ʻōpū ke haʻi inā aia ka paʻa.

Ke loaʻa ke kumu, ʻo ka pahuhopu o ka mālama ʻana e kōkua i kāu mau puʻupaʻa e hana hou a pale i ka wai a me nā ʻōpala mai ke kūkulu ʻana i kou kino i ka wā e ola ai. ʻO ka maʻamau, pono ʻoe e noho i ka pō i ka haukapila no ka mālama ʻana.

E kaupalena ʻia ka nui o ka wai āu e inu ai i ka nui o ka mimi hiki iā ʻoe ke hana. E haʻi ʻia iā ʻoe i ka mea āu e ʻai ai a ʻai ʻole paha e hōʻemi i ke kūkulu ʻia ʻana o nā lāʻau make a nā hakuʻala e hemo mau ai. Pono paha kāu papaʻai e kiʻekiʻe i nā huaʻaleʻale a haʻahaʻa i ka protein, ka paʻakai, a me ka potassium.

Pono ʻoe i nā antibiotic e mālama a pale i ka maʻi. Hiki ke hoʻohana ʻia nā pila wai (diuretics) e kōkua i ka lawe ʻana i ka wai mai kou kino.

E hāʻawi ʻia nā lāʻau i loko o ke aa e kōkua i ke kaohi i kou pae potassium.

Hiki paha iā ʻoe ke dialysis. He lapaʻau kēia e hana ana i ka hana maʻamau o nā puʻupaʻa olakino - kāpae i ke kino i nā ʻōpala hōʻino, keu paʻakai, a me ka wai. Hiki i ka Dialysis ke hoʻopakele i kou ola inā kiʻekiʻe kiʻekiʻe kāu pae potassium. E hoʻohana ʻia ka dialysis inā:

• Ua loli kou kūlana noʻonoʻo
• Hoʻolālā ʻoe i ka pericarditis
• Mālama nui ʻoe i ka wai
• ʻAʻole hiki iā ʻoe ke hemo i nā huahana neoneo nitrogen mai kou kino

ʻO ka Dialysis kahi manawa pōkole loa. I kekahi mau hihia, nui loa ka hōʻino ʻana o ka puʻupaʻa e pono mau ai ka dialysis.

Kāhea i kāu mea hāʻawi inā lohi a kū paha kāu hana mimi a i ʻole loaʻa iā ʻoe kekahi mau ʻōuli ʻē aʻe o ka hōʻino ʻole o ka hakuʻala.

I mea e pale aku ai i nā kōkō hōʻino nui:

• Pono e kāohi maikaʻi ʻia nā pilikia olakino e like me ke koko kiʻekiʻe a i ʻole ka maʻi kō.
• Hōʻalo i nā lāʻau a me nā lāʻau i hiki ke hōʻeha i ka hakuʻala.

Hewa puʻupaʻa; Hōʻeha kīnā ʻole; Hewa kō ʻole - hōʻeha; ARF; ʻEha ʻino - hōʻino

• Anatomia hakuʻala

ʻO Molitoris BA. ʻEha puʻuwai koʻikoʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 112.

ʻO MS, Briefel G. Ka loiloi ʻana i ka hana o ke kōpaʻa, ka wai, nā electrolytes, a me ke kaulike acid-base. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 14.

Weisbord SD, Palevsky PM. Kāohi a me ka mālama ʻana i ka ʻeha puʻuwai koʻikoʻi. 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 29.