Nā pae o ka maʻi maʻi kīnā

Anter

• Overview o nā pae
• Ka helu kānana Glomerular (GFR)
• ʻO ke kahua maʻi maʻi maʻi 1
• Nā ʻōuli
• Lapaʻau
• ʻO ka maʻi maʻi ʻōpū 2
• Nā ʻōuli
• Lapaʻau
• ʻO ke kahua maʻi maʻi ʻōpū 3
• Nā ʻōuli
• Lapaʻau
• ʻO ka maʻi maʻi ʻōpū 4
• Nā ʻōuli
• Lapaʻau
• ʻO ke kahua maʻi maʻi 5
• Nā ʻōuli
• Lapaʻau
• Hemodialisis
• Dialysis Peritoneal
• Nā lawe lawe kī

Nui nā hana a nā hakuʻala i ke olakino maikaʻi. Hana lākou ma ke ʻano he kānana no kou koko, hoʻoneʻe i nā ʻōpala, nā mea make, a me nā wai keu.

Kōkua pū lākou i:

• hoʻoponopono i ke koko a me nā kemikō o ke koko
• mālama i nā iwi i ke olakino a hoʻonāukiuki i ka hana ʻana o ke aʻa koko

Inā loaʻa ʻoe i ka maʻi ʻōpū mau (CKD), ua ʻino ʻoe i kou puʻupaʻa ma mua o kekahi mau mahina. ʻAʻole kānana nā puʻupaʻa hōʻino i ke koko e like me ka mea e pono ai, kahi e alakaʻi ai i nā ʻano hopohopo olakino koʻikoʻi.

Aia he ʻelima pae o ka CKD a me nā ʻōuli ʻokoʻa a me nā hana e pili ana i kēlā me kēia pae.

Kuhi nā Centres for Disease Control and Prevention (CDC) i ka loaʻa ʻana o ka CKD i nā mākua o ʻAmelika Hui Pū ʻIa, akā ʻaʻole ʻike ʻia ka hapanui. He kūlana holomua ia, akā hiki i ka lapaʻau ke hoʻohiohi. ʻAʻole hiki i nā mea āpau ke holomua i ke kōpaʻa.

Overview o nā pae

E hāʻawi i kahi pae CKD, pono i kāu kauka e hoʻoholo i ka maikaʻi o ka hana o kāu mau puʻupaʻa.

ʻO kahi ala e hana ai i kēia me kahi hōʻike mimi e loiloi i kāu lakene albumin-creatinine (ACR). Hōʻike ia inā e kahe ana ka protein i ka mimi (proteinuria), kahi hōʻailona o ka hōʻino ʻana o ka hakuʻala.

Hana ʻia nā pae ACR penei:

Hiki paha i kāu kauka ke kauoha i nā hoʻokolohua kiʻi, e like me ka ultrasound, e nānā i ke ʻano o kāu mau puʻupaʻa.

Hoʻopili kahi hoʻokolohua koko i ka creatinine, urea, a me nā huahana ʻōpala ʻē aʻe i ke koko e ʻike i ka maikaʻi o ka hana o nā puʻupaʻa. Kāhea ʻia kēia i ka helu helu kānana glomerular (eGFR). He GFR o 100 mL / min maʻamau.

Hōʻike kēia papa i nā pae ʻelima o CKD. ʻO ka ʻike hou aku e pili ana i kēlā me kēia pae ma hope o ka papa.

Ka helu kānana Glomerular (GFR)

GFR, a i ʻole ka helu kānana glomerular, hōʻike i ka nui o ke kānana o kou puʻupaʻa i 1 minuke.

ʻO ke kumuhana e helu ai i ka GFR me ka nui o ke kino, ka makahiki, ka wahine, a me ka lāhui. Me ka ʻole o nā hōʻike ʻē aʻe o nā pilikia kīnā, kahi GFR ma lalo o 60 hiki ke noʻonoʻo ʻia he maʻamau.

Hiki ke alakaʻi hewa i nā ana GFR inā, no ka laʻana, he mea kūkulu kino ʻoe a i ʻole he maʻi ʻai.

ʻO ke kahua maʻi maʻi maʻi 1

I ka pae 1, aia he ʻino maikaʻi loa i nā puʻupaʻa. Ua maʻalahi lākou a hiki ke hoʻoponopono no kēia, e ʻae iā lākou e hoʻomau i ka hana ʻana ma 90 pākēneka a ʻoi aku paha.

I kēia manawa, e ʻike wale ʻia ʻo CKD ma kahi o ka manawa maʻamau i nā hoʻokolohua koko a me ka mimi maʻamau. Loaʻa paha iā ʻoe kēia mau hoʻokolohua inā loaʻa ʻoe i ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, nā kumu kiʻekiʻe o CKD ma United States.

Nā ʻōuli

ʻO ka maʻamau, ʻaʻohe mau hōʻailona ke holo nā puʻupaʻa ma 90 pākēneka a ʻoi aku paha.

Lapaʻau

Hiki iā ʻoe ke hoʻolohi i ka holomua o ka maʻi ma ke kau ʻana i kēia mau ʻanuʻu:

• E hana i ka mālama ʻana i nā pae kō kō inā loaʻa ʻoe i ka maʻi diabetes.
• E hāhai i ka ʻōlelo aʻoaʻo a kāu kauka no ka hoʻohaʻahaʻa ʻana i ke kahe o ke koko inā loaʻa iā ʻoe ke kiʻekiʻe.
• Mālama i kahi papaʻai olakino, kaulike.
• Mai hoʻohana i ka paka.
• Hana i ka hoʻoikaika kino no 30 mau minuke i ka lā, ma ka liʻiliʻi he 5 mau lā o ka pule.
• E hoʻāʻo e mālama i kahi kaupaona kūpono no kou kino.

Inā ʻaʻole ʻoe i ʻike i kekahi loea hakuʻala (nephrologist), e noi i kāu kauka laulaha e kuhikuhi iā ʻoe i kekahi.

ʻO ka maʻi maʻi ʻōpū 2

I ka pae 2, ke holo nei nā puʻupaʻa ma waena o 60 a me 89 pakeneka.

Nā ʻōuli

I kēia manawa, noa ʻole ʻoe i hōʻailona. A i ʻole nā ​​hōʻailona ʻaʻole pono, e like me:

• luhi
• ʻūlili
• nalo ʻai ʻole
• pilikia pilikia hiamoe
• nāwaliwali

Lapaʻau

ʻO ka manawa kēia e hoʻomohala i kahi pilina me kahi loea hakuʻala. ʻAʻohe mea ola no CKD, akā hiki i ka mālama mua ʻana ke hoʻolohi a kū i ka holomua.

He mea nui e hoʻoponopono i ke kumu kumu. Inā loaʻa ʻoe i ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole nā ​​maʻi puʻuwai, e hāhai i nā ʻōlelo aʻoaʻo a kāu kauka no ka mālama ʻana i kēia mau ʻano.

He mea nui nō hoʻi e mālama i kahi papaʻai maikaʻi, loaʻa i ka hoʻoikaika kino maʻamau, a mālama i kou kaupaona. Inā puhi ʻoe, e nīnau i kāu kauka e pili ana i nā polokalamu hoʻomaha puhipaka.

ʻO ke kahua maʻi maʻi ʻōpū 3

ʻO ka pae 3A ke ʻano o kou ʻōpū ma waena o 45 a me 59 pākēneka. ʻO ke kahua 3B ʻo ia ka hana o ka hakuʻala ma waena o 30 a me 44 pākēneka.

ʻAʻole kānana maikaʻi nā puʻupaʻa i nā ʻōpala, nā mea make, a me nā wai a ke hoʻomaka nei kēia e kūkulu.

Nā ʻōuli

ʻAʻole nā ​​kānaka āpau i nā ʻōuli ma ke kahua 3. Akā loaʻa paha iā ʻoe:

• ʻeha kua
• luhi
• nalo ʻai ʻole
• ʻumeʻume mau
• pilikia pilikia hiamoe
• pehu o na lima a me na wawae
• urencing ʻoi aku a i ʻole emi ma mua o ka maʻamau
• nāwaliwali

Komo pū nā pilikia:

• anemia
• maʻi maʻi iwi
• kahe koko kiʻekiʻe

Lapaʻau

He mea nui ka mālama ʻana i nā kūlana i lalo e kōkua i ka mālama ʻana i ka hana o ka hakuʻala. Hoʻopili paha kēia:

• nā lāʻau lapaʻau kiʻekiʻe loa e like me ka angiotensin-hoʻololi i ka enzyme (ACE) mea kāpae a i ʻole angiotensin II receptor blockers
• nā diuretics a me ka papa paʻakai haʻahaʻa e hōʻoluʻolu i ka paʻa ʻana o ka wai
• nā lāʻau hoʻohaʻahaʻa kolesterol
• nā mea kōkua erythropoietin no ka anemia
• wikamina D nā mea hoʻopili e hoʻoponopono i nā iwi nāwaliwali
• nā mea paʻa phosphate e pale aku i ka helu ʻana i nā kīʻaha koko
• ka ukali ʻana i ka papaʻai protein haʻahaʻa no laila ʻaʻole pono e hana paʻakikī kou mau puʻupaʻa

Pono paha ʻoe i nā kipa ukali pinepine a me nā hoʻokolohua no laila hiki i nā hoʻoponopono ke pono inā pono.

Hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi dietitian e hōʻoia i ka loaʻa ʻana o nā meaʻai āpau āu e pono ai.

ʻO ka maʻi maʻi ʻōpū 4

ʻO ka pae 4 ʻo ia hoʻi he hōʻeha kou naʻau. Ke hana nei lākou ma waena o 15 a 29 pakeneka, no laila ke kūkulu nei paha ʻoe i nā ʻōpala, nā mea make, a me nā wai i loko o kou kino.

Pono ʻoe e hana i nā mea āpau e pale ai i ka holomua i ka holo pono ʻole ʻana o ka hakuʻala.

Wahi a ka CDC, ʻo ka poʻe me ka hoʻohaʻahaʻa nui ʻana i ka hana o ka puʻuwai ʻaʻole lākou i ʻike.

Nā ʻōuli

Hiki i nā ʻōuli ke hoʻohui pū:

• ʻeha kua
• ʻeha ka umauma
• hoʻēmi i ka ʻoi loa o ka noʻonoʻo
• luhi
• nalo ʻai ʻole
• mimikī o nā mākala a i ʻole ke ʻūlū
• nausea a me ka luaʻi
• ʻumeʻume mau
• pokole o ka hanu
• pilikia pilikia hiamoe
• pehu o na lima a me na wawae
• urencing ʻoi aku a i ʻole emi ma mua o ka maʻamau
• nāwaliwali

Hiki i nā pilikia ke hoʻopili:

• anemia
• maʻi maʻi iwi
• kahe koko kiʻekiʻe

Hoʻonui pū ʻia ʻoe me ka maʻi puʻuwai a me ka hahau.

Lapaʻau

I ka pae 4, pono ʻoe e hana pili loa me kāu kauka. Ma waho aʻe o ka mālama like ʻana e like me nā pae ma mua, pono ʻoe e hoʻomaka i nā kūkā kamaʻilio e pili ana i ka dialysis a me nā transplan kidney inā ʻaʻole e pau kāu mau puʻupaʻa.

Lawe kēia mau kaʻina hana i ka hoʻonohonoho pono a me ka manawa nui, no laila he naʻauao ke loaʻa kahi hoʻolālā ma kēia wahi.

ʻO ke kahua maʻi maʻi 5

ʻO ke kahua 5 ke ʻano o ka hana ʻana o kou mau puʻupaʻa ma lalo o 15 pakeneka hiki a i ʻole loaʻa ʻole ʻoe i ka puʻupaʻa.

Ke kū kēlā, lilo ke kūkulu ʻana i nā ʻōpala a me nā toxins i mea hoʻoweliweli i ke ola. ʻO kēia ka maʻi hōʻino hope loa.

Nā ʻōuli

Hiki i nā ʻōuli o ke kōpaʻa ʻole ke komo pū:

• ʻeha ke kua a me ka umauma
• nā pilikia hanu
• hoʻēmi i ka ʻoi loa o ka noʻonoʻo
• luhi
• iki i ka makemake ʻole
• mimikī a i ʻole ke kuʻi ʻana o ka mākala
• nausea a luaʻi paha
• ʻumeʻume mau
• pilikia hiamoe
• nāwaliwali loa
• pehu o na lima a me na wawae
• urencing ʻoi aku a i ʻole emi ma mua o ka maʻamau

Ke ulu nei ka makaʻu o ka maʻi puʻuwai a me ka hahau.

Lapaʻau

Ke loaʻa pono ʻole ʻoe i ka hakuʻala, he mau mahina wale nō ke kali ʻana o ke ola me ka ʻole o ka dialysis a i ʻole ke kuʻina kōwi.

ʻAʻole kahi lāʻau Dialysis i mea e hōʻola ai i ka maʻi o ka puʻupaʻa, akā he hana e hemo ai ka ʻōpala a me ka wai mai kou koko. ʻElua mau ʻano o ka dialysis, hemodialysis a me ka dialysis peritoneal.

Hemodialisis

Hana ʻia ʻo Hemodialysis ma kahi kikowaena dialysis ma kahi papa manawa i hoʻonohonoho ʻia, ma ka manawa maʻamau he 3 mau manawa o ka pule.

Ma mua o kēlā me kēia lapaʻau ʻana, kau ʻia nā nila ʻelua i kou lima. Hoʻopili lākou i kahi dialyzer, kahi i kapa ʻia i kekahi manawa me he puʻupaʻa hana. Hoʻopili ʻia kou koko ma o ka kānana a hoʻihoʻi ʻia i kou kino.

Hiki iā ʻoe ke hoʻomaʻamaʻa e hana i kēia ma ka home, akā koi ʻia i kahi kaʻina hana e hana i ke komo ʻana o ke aa koko. Hana pinepine ʻia ka dialysis home ma mua o ka dialysis i kahi kikowaena mālama.

Dialysis Peritoneal

No ka dialysis peritoneal, e loaʻa iā ʻoe kahi catheter surgically i loko o kou ʻōpū.

I ka wā o ka mālama ʻana, kahe kahe dialysis ma o ka catheter i loko o ka ʻōpū, a ma hope e hiki ai iā ʻoe ke hele i kou lā maʻamau. I kekahi mau hola ma hope, hiki iā ʻoe ke hoʻokahe i ka catheter i loko o kahi ʻeke a hoʻolei aku iā ia. Pono e hana hou i kēia i 4 i 6 mau manawa i ka lā.

Hoʻopili kahi transplant puʻupaʻa i ke kuapo ʻana i kou puʻupaʻa me kahi mea olakino. Hiki i nā puʻupaʻa ke hele mai mai nā mea kōkua ola a i make paha. ʻAʻole ʻoe e pono i ka dialysis, akā pono ʻoe e inu i nā lāʻau anti-rejection no ke koena o kou ola.

Nā lawe lawe kī

Aia he 5 pae o ka maʻi maʻi kō. Hoʻoholo ʻia nā pae me nā hoʻokolohua koko a me ka mimi a me ke kiʻekiʻe o ka hōʻino ʻana o ka hakuʻala.

ʻOiai he maʻi holomua ia, ʻaʻole e hele ka poʻe āpau e ulu i ke kīkole ʻole.

Hōʻailona nā ʻōuli o nā maʻi ʻōiwi mua a hiki ke nānā maʻalahi ʻia. ʻO ia ke kumu he mea nui ka loaʻa ʻana o nā hōʻoia maʻamau inā loaʻa ʻoe i ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, nā kumu nui o nā maʻi puʻupaʻa.

Hiki i ke kuhi mua a me ka hoʻokele ʻana o ke ʻano o ke ola ʻana ke kōkua i ka lohi a pale paha i ka holomua.