So asikreyare ka asaabo nso? Momma yɛnhwɛ Asikreyare Asaabo Yare!

So wowɔ asikreyare? Anaasɛ obi a ɔwɔ asikreyare wɔ w’abusua anaa w’adamfo? Afei ebia wunim ɔhaw ahorow a asikreyare de ba no. Ɛtɔ da bi a, yetumi suro efisɛ yennim eyinom yiye. Ɛnnɛ yɛrebɛka nkɛntɛnso a asikreyare betumi anya wɔ yɛn asaabo so ho asɛm. Wɔfrɛ eyi Asikreyare Asaabo Yare (DKD).

Dɛn ne Asikreyare Asaabo Yare (Asikreyare Asaabo Yare)?

Sɛ yɛbɛka no tiawa a, eyi yɛ w’asaabo a asikreyare asɛe no. Yenim sɛ asaabo abien a ɛwɔ yɛn nipadua mu no yi mogya no mu na eyi nneɛma fĩ fi mu . Fa no sɛ asaabo no yɛ super filters abien wɔ yɛn nipadua mu. Eyinom yi nwura a nitrogen wom, sɛ nhwɛso no, urea, nwura a efi ntini mu (creatinine), ne awuduru afoforo pii mu na wɔde nsu fi mu. Ɛnyɛ ɛno nko, na mmom asaabo no nso boa ma nsu ne anyinam ahoɔden a ɛwɔ nipadua no mu no kari pɛ.

Asaabo biara kura nneɛma nketenkete bɛboro ɔpepem biako a wɔde yiyi mu a wɔfrɛ no nephrons. Wɔ saa nephrons yi mu no, mogya ntini nketenkete a ɛka bom yɛ ade a ɛte sɛ ahama a wɔfrɛ no glomeruli. Nokwarem no, saa glomeruli yi ne ade a edi kan a wɔde yi mogya mu. Wɔma nsu ne nwura a apete fa wɔn ntini a ɛyɛ fã bi a ɛtumi fa mu no mu, na afei wɔyi fi nipadua no mu sɛ nsuo.

Afei hwɛ, dɛn na ɛba obi a ɔwɔ asikreyare nipadua so? Wɔn nipadua ntumi mfa asikre a yenya fi aduan a yedi mu, kyerɛ sɛ, `(glucose)` no nni dwuma yiye. Afei `(glucose)` dodow a ɛwɔ mogya no mu no kɔ soro. Sɛ `(glucose)` dodow a ɛkɔ soro yi wɔ hɔ bere tenten a, saa `(glomeruli)` no ntini a ɛyɛ mmerɛw no fi ase sɛe. Na `(nephron)` no afã afoforo nso betumi asɛe. `(glomeruli)` a asɛe wɔ saa kwan yi so no ntumi nkɔyi mogya no yiye. Afei, nea ɛba ne sɛ awuduru a ɛsɛ sɛ wɔde fi nsu mu no fi ase boaboa ano wɔ nipadua no mu.

So tebea yi yɛ aniberesɛm?

Yiw, asaabo mu yare a asikreyare de ba no yɛ tebea a emu yɛ den . Sɛ wɔanhwɛ so yiye a, awiei koraa no ebetumi ama asaabo ayɛ adwuma yiye . Asaabo a entumi nyɛ adwuma yiye no betumi de ne nkwa ato asiane mu. Enti, ɛho hia paa sɛ yehu eyi.

Dɛn ne asaabo mu yare a asikreyare de ba no?

eGFR yɛ nea ɛkyerɛ sɛnea w’asaabo reyɛ adwuma yiye. eGFR yɛ asɛmfua tiawa a ɛkyerɛ sɛnea wɔabu akontaa sɛ glomerular filtration rate. Sɛ yɛbɛka no tiawa a, ɛyɛ akontaabu a ɛkyerɛ sɛnea w’asaabo yi nneɛma a wɔsɛe no yiye. Obi a ɔwɔ apɔwmuden eGFR bɛyɛ 100. Saa bo yi betumi akɔ fam akodu 0, a ɛkyerɛ sɛ w’asaabo ntumi nyɛ adwuma koraa.

Asaabo mu yare biara wɔ akwan horow pii so, a asaabo mu yare a asikreyare de ba ka ho:

• Ɔfã I:Wo GFR yɛ 90 anaa nea ɛboro saa. Saa bere yi de, ebia w’asaabo asɛe kakra, nanso ɛda so ara yɛ adwuma sɛnea ɛsɛ.
• Ɔfã II: GFR bo betumi ayɛ 60 kosi 89. Asaabo no asɛe kɛse sen ɔfã I, nanso ɛda so ara yɛ adwuma yiye.
• Ɔfã III: GFR bo betumi ayɛ 30 kosi 59. Saa bere yi de, asaabo dwumadi betumi atew kakra anaasɛ ɛbɛtew kɛse.
• Ɔfã IV: GFR bo betumi ayɛ 15 kosi 29. Eyi kyerɛ sɛ asaabo dwumadi so atew kɛse.
• Ɔfã V: GFR no nnu 15. Eyi kyerɛ sɛ asaabo no abɛn sɛ ebetumi adi nkogu koraa, anaasɛ adi nkogu.

Hena na ɛda adi kɛse sɛ obenya saa yare yi? Dɛn ne nneɛma a ɛde asiane ba?

Obiara a ɔwɔ asikreyare a ɛto so 1 anaa Type 2 betumi anya asaabo mu yare. Nanso, nnipa binom wɔ asiane kɛse mu. Nhwɛsoɔ:

• Abibifo a wɔyɛ abibifo
• Amerika Indiafo, Alaska Abibifo, anaa Amanaman a Edi Kan no mufo
• Polynesiafo a wɔyɛ nnipa
• Maorifo a wɔyɛ nnipa

Asiane afoforo nso wɔ hɔ:

• Asaabo mu yare a wobenya wɔ abusua no mu.
• Mogya mmoroso a obi wɔ.
• Tawa nneɛma (te sɛ sigaret) a wɔde di dwuma.
• Hyperglycemia yɛ tebea a asikre dodow a ɛwɔ mogya mu no kɔ soro bere nyinaa.
• Mogya mu srade a ɛkɔ soro (Hyperlipidemia).

Saa yare yi abu so dɛn?

Asaabo mu yare a asikreyare de ba no yɛ tebea a abu so yiye . Ɛno ne ade titiriw a ɛde adwene mu yare a ɛba awiei ba wɔ wiase nyinaa. Wobu akontaa sɛ nnipa a wɔwɔ asikreyare no mu bɛyɛ 40% na wonya saa asaabo mu yare yi.

Dɛn ne asaabo mu yare a asikreyare de ba no ho sɛnkyerɛnne?

Mpɛn pii no, sɛnkyerɛnne a ɛda adi pefee no nna adi kosi sɛ asaabo no mu 80% kosi 90% bɛsɛe. Sɛ sɛnkyerɛnne ahorow no da adi ampa a, ebia wubehu nneɛma te sɛ:

• Anim, nsa, ne nan a ɛho ahonhon (edema).
• Akisikuru ne ɔfe.
• Ɔbrɛ anaa ɔbrɛ a wɔte nka bere nyinaa.
• Ɔhome a ɛyɛ den (dyspnea).
• Aduan no nyɛ dɛ.
• Nsu a ɛyɛ ahuru anaasɛ ɛyɛ bubbly.
• Ɛyɛ den sɛ wode w’adwene besi biribi so anaasɛ wobɛte nka sɛ w’adwene atu afra.
• Wora a ɛyɛ nwunu na ɛyɛ wo yaw.
• Ntini mu akisikuru.
• Ɛho hia sɛ wɔtew insulin dodow a wɔnom so (ma wɔn a wɔnom nnuru a wɔde sa asikreyare).

Dɛn ne sɛnkyerɛnne ahorow a ɛwɔ mfiase no mu?

Asaabo mu yare a efi asikreyare mu ba no ntaa nna sɛnkyerɛnne biara adi wɔ ne mfiase.. Ebia wowɔ protein wɔ wo nsu mu (proteinuria). Nanso oduruyɛfo a ɔyɛ nsu mu nhwehwɛmu nkutoo na obetumi ahu eyi.

Dɛn na ɛde eyi ba? So ɛyɛ ɔyare mmoawa?

Ade titiriw nti a ɛte saa ne asikreyare a ɛto so 1 anaa nea ɛto so abien a obi benya.

Dabi, eyi nyɛ yare a ɛde ɔyare mmoawa ba. Worentumi ntrɛw yare yi mu mma obi foforo biara.

Wobɛyɛ dɛn ahu sɛ asikreyare nti wowɔ asaabo mu yare?

Sɛ wowɔ asikreyare a, ɛho hia sɛ wokɔ wo duruyɛfo nkyɛn asram abiɛsa kosi asia biara kɔhwɛ wo, sɛnea wo duruyɛfo kamfo kyerɛ no. Sɛ wo duruyɛfo susuw sɛ ebia wowɔ asaabo mu yare a efi asikreyare mu a, ɔbɛhyɛ sɛ wɔnyɛ nhwehwɛmu bi.

Sɔhwɛ ahorow bɛn na wɔyɛ de hu eyi?

Nhwehwɛmu ahorow a edidi so yi boa ma wohu yare yi:

• Nsu mu nhwehwɛmu:

Nea ɛka eyi ho ne sɛ wobɛfa wo nsu no bi na woahwehwɛ mu ahwɛ sɛnea ɛte, nnuru a ɛwom, ne nhwehwɛmu a wɔde afiri ketewaa bi ayɛ. Ebia wo duruyɛfo de dipstick bɛyɛ nhwehwɛmu yi. Ebia ɔbɛkamfo nsu mu nhwehwɛmu ahorow nso akyerɛ. Wɔ dipstick sɔhwɛ mu no, wototo wo ho gu ade titiriw bi mu. Afei wɔde krataa a wɔde kyekyere (dipstick) a nnuru a wɔde apete so gu so. Sɛ protein (albumin) wɔ nsu no mu a, nhama no kɔla bɛsesa.

Sɛ wo duruyɛfo hia susudua a ɛyɛ pɛpɛɛpɛ a, ebia ɔbɛhyɛ sɛ wɔnyɛ protein nhwehwɛmu wɔ nsu mu . Eyi hwehwɛ sɛ wode wo nsu no nhwɛsode bi bɛkɔ lab kɔhwɛ sɛnea protein ne creatinine a ɛwɔ wo nsu mu no yɛ pɛ (protein ne creatinine nsusuwii). Sɛ saa dodow yi dɔɔso dodo a, ebetumi ayɛ asaabo mu yare a efi asikreyare mu ho sɛnkyerɛnne.

• Mogya mu nhwehwɛmu:

eGFR nhwehwɛmu no susuw tumi a w’asaabo tumi yi mogya mu. Wo duruyɛfo no begye mogya kakraa bi afi ntini bi a ɛwɔ wo nsa mu mu na ɔde creatinine dodow a ɛwɔ mogya no mu ne akwahosan ho nsɛm atitiriw bi adi dwuma de abu wo eGFR.

• Mfoninitwa sɔhwɛ ahorow:

Saa nhwehwɛmu ahorow yi betumi aboa wo duruyɛfo ma wanya w’asaabo akwahosan ho adwene.

• Ultrasound nhwehwɛmu: Eyinom betumi ahwɛ sɛnea asaabo no te ne ne kɛse.
• MRI ne CT scan: Eyinom tumi hu mogya ntini ne mogya a ɛkɔ asaabo mu no pefee.

• Asaabo mu nhwehwɛmu:

Wɔ saa adeyɛ yi mu no, oduruyɛfo no yi ntini ketewaa bi fi w’asaabo mu na ɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu wɔ aduruyɛdan mu. Ansa na wobɛyɛ eyi no, beae no yɛ mmerɛw sɛnea ɛbɛyɛ a worente ɛyaw biara. Ɔbɛma wo aduru a emu nyɛ duru a ɛma wo ho dwo wo nso na aboa wo ma woagye w’ahome. Afei, wɔde ade bi fa honam ani kɔ asaabo no mu na wɔfa ntini no nhwɛsode.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Ayaresa no gyina baabi a wo yare no wɔ, mfe a woadi, ne w’akwahosan nyinaa so. Wo asikreyare a wubedi so ne ade a edi kan a ɛsɛ sɛ woyɛ de sa asaabo mu yare yi. Nneɛma a edidi so yi betumi aboa wo ma woadi wo asikreyare no ho dwuma:

• Fa nnuan a ahoɔdennuru pii wom, srade ne calories pii wom ka w’aduan ho.
• Apɔw-mu-teɛteɛ a wɔyɛ no daa.
• Nipadua mu duru a wɔhwɛ so.
• Gyae sigaretnom anaa tawa nneɛma afoforo a wode bedi dwuma.

Sɛ wowɔ mogya mmoroso a, ɛho hia sɛ wosa no nso. Ebia wo duruyɛfo bɛkyerɛw nnuru a wɔde sa mogya mmoroso.

So wobetumi asan asaabo a asɛe no?

Dabi, wontumi nsakra asaabo a asikreyare de ba no koraa. Nanso, wubetumi adi asaabo a ɛsɛe bio no so, ayɛ brɛoo, na ebia mpo agyae denam nnuru a wobɛnom sɛnea wo duruyɛfo akyerɛ wo no, aduan pa a wubedi akyi, na woakɔ so ayɛ apɔw-mu-teɛteɛ so.

Nnuru bɛn na wɔde ma wɔ eyi ho?

To manage diabetic kidney disease, it is important to control your diabetes, lower your blood pressure, and lower your cholesterol levels. Ebia wo duruyɛfo bɛkyerɛw nnuru a edidi so yi de asa tebea horow yi:

• Wɔ asikreyare ho no:
• Biguanides (e.g. metformin): Eyinom tew glucose dodow a wo mmerɛbo yɛ so. Wɔma ɔkwan a insulin fa so yɛ adwuma wɔ nipadua no mu nso tu mpɔn, na ɛma sɛnea carbohydrates dan asikre no brɛ ase.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors: Eyinom boa ma asaabo no fa asaabo ne nsu mu yi glucose fi nipadua no mu.
• Glucagon-like peptide 1 (GLP-1) agonists: Eyinom ma insulin a ɛba no yɛ kɛse, ɛtew glucose a ɛba mmerɛbo no mu bere a wɔadi adidi akyi, na ɛkyɛ yafunu mu a ɛda mpan. Eyi nso betumi aboa ma obi mu duru so atew.

• Sɛ wopɛ mogya mmoroso a:
• Angiotensin-converting enzyme (ACE) inhibitors: Eyinom siw hormone bi a wɔfrɛ no angiotensin II a wɔyɛ no kwan. Nipadua no fi awosu mu de saa hormone yi di dwuma de hwɛ mogya mmoroso so. Sɛ wɔde nnuru a esiw ACE ano sa yare wie a, ɛsɛ sɛ mogya mmoroso so tew.
• Angiotensin II receptor blockers (ARBs): Eyinom siw hormone angiotensin II no kwan sɛ ɛbɛkyekyere ntini ahorow a ɛwɔ mogya ntini no so no. ARB ahorow no yɛ adwuma wɔ ɔkwan a ɛte sɛ nnuru a esiw ACE ano no so, na ɛtew mogya mmoroso so.

Nea ɛho hia: Wɔ mogya mmoroso a wɔtew akyi no, nnuru a esiw ACE ano ne ARB ahorow nso boa ma asaabo mu yare a efi asikreyare mu no kɔ so brɛoo.

• Sɛ wopɛ srade a ɛdɔɔso a:
• Statins: Eyinom ma srade bɔne so tew na ɛma srade pa kɔ soro. Ebia wɔbɛboa nnipa bi a wɔwɔ asaabo mu yare a asikreyare de ba no.

Sɛ yare no mu yɛ den a, dɛn na wɔde sa yare?

Sɛ asikreyare asaabo mu yare mu yɛ den a, ayaresa a wobetumi apaw bi ne:

• Dialysis: Sɛ w’asaabo ntumi nyɛ adwuma yiye a, dialysis betumi ayɛ adwuma no ama w’asaabo. Wɔ eyi mu no, afiri bi fa wo mogya, yi nneɛma fĩ ne nsu a ɛboro so fi mu, na ɛsan de mogya a wɔatew ho no kɔ wo nipadua mu.
• Asaabo a wɔde si ananmu: Wɔ eyi mu no, wunya asaabo a ɛte apɔw fi obi foforo (ɔyɛ obi a ɔde asaabo ma).

Wobɛyɛ dɛn atumi akwati yare yi?

Ɔkwan a eye sen biara a wobɛfa so asiw asaabo mu asikreyare ano ne sɛ wubedi wo asikreyare ne wo mogya mmoroso ho dwuma yiye. Ɛho hia sɛ wudi ayaresa nhyehyɛe a wo duruyɛfo akyerɛw ama wo no akyi pɛpɛɛpɛ.

Dɛn na obi a ɔwɔ saa yare yi betumi ahwɛ kwan?

Asikreyare asaabo mu yare yɛ tebea a ɛkɔ so nkakrankakra . Sɛ wowɔ saa yare yi a, worentumi nsakra sɛnea w’asaabo asɛe no. Nanso, sɛ wunya yare no ntɛm na wudi ayaresa nhyehyɛe a ɛfata akyi a, wubetumi ama yare no akɔ so brɛoo anaa mpo agyae.

Sɛ saa yare yi mu yɛ den a, ebetumi ama asaabo asɛe, na ɛde nkwa to asiane mu. Ayaresa a wobetumi apaw ama asaabo a entumi nyɛ adwuma yiye ne dialysis anaa asaabo a wɔde bɛma obi foforo.

Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ho?

Wo duruyɛfo bɛboa wo ma woayɛ ayaresa nhyehyɛe a ɛfata wo. Ebia nea ɛka ho ne nnuru ne asetra mu nsakrae. Ebia wo ayaresa nhyehyɛe no bi ne:

• Asikreyare ne mogya mmoroso nnuru a oduruyɛfo no akyerɛw ama no a wɔbɛnom pɛpɛɛpɛ.
• Hwɛ asikre dodow a ɛwɔ wo mogya mu ne mogya mmoroso daa.
• Aduan a ahoɔden wom a wobedi akyi (te sɛ Mediterranea aduan anaa DASH aduan).
• Anyɛ yiye koraa no, teɛteɛ w’apɔw mu simma 30 da biara wɔ dapɛn no mu nna dodow no ara. Bɔ mmɔden sɛ anyɛ yiye koraa no wobɛteɛteɛ w’apɔw mu simma 150 dapɛn biara. Wubetumi anantew, atu mmirika, abɔ sakre, asuguare, anaa woayɛ koma ne ntini mu dwumadi foforo biara a w’ani gye ho.
• Nnuru a ebetumi asɛe asaabo a wobɛkwati. Ebia eyi bɛka nnuru bi a wɔde kum ɛyaw (nnuru a ɛnyɛ steroid a ɛko tia ɔyare mmoawa - NSAIDs).
• Oduruyɛfo a wɔbɛkɔ akɔhwɛ na wɔayɛ lab nhwehwɛmu nyinaa.
• Gyae sigaretnom anaa tawa nneɛma afoforo a wode bedi dwuma.
• Nsã dodow a wobɛnom no ano hye.
• Da nnɔnhwerew ason kosi akron anadwo biara.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ asikreyare a, ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn daa asram abiɛsa kosi asia biara, sɛnea wo duruyɛfo kamfo kyerɛ no.

Sɛ wowɔ asikreyare a, wo duruyɛfo bɛkamfo akyerɛ sɛ ɛsɛ sɛ wohwehwɛ asaabo mu yare a ɛwɔ asikreyare mu afe biara , na efi ase mfe anum wɔ bere a wɔahu sɛ wowɔ no akyi. Mpɛn pii no, asaabo a asɛe no nna adi wɔ mfe 10 a edi kan bere a wɔahu sɛ wowɔ asikreyare akyi no. Sɛ woanya asikreyare bɛboro mfe 25 na w’asaabo nsɛee a, ɛnyɛ den koraa sɛ wubenya asikreyare asaabo mu yare.

Nsɛm bɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Ɛho hia yiye sɛ wubebisa nsɛm te sɛ eyinom bere a worekɔ wo duruyɛfo nkyɛn no:

• Wobɛyɛ dɛn ahu sɛ asikreyare nti mewɔ asaabo mu yare?
• So ɛsɛ sɛ mekɔ nephrologist anaa ɔbenfo foforo nkyɛn?
• Nhwehwɛmu bɛn na woyɛ de hu asaabo mu yare a efi asikreyare mu?
• Asikreyare m’asaabo mu yare no mu yɛ den dɛn?
• Nsakrae bɛn na metumi ayɛ wɔ asetra mu na ama m’asaabo mu yare a asikreyare de aba no akɔ so brɛoo anaasɛ agyae?
• Nnuru bɛn na wokamfo kyerɛ?
• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• Mpɛn ahe na ɛsɛ sɛ meba bɛyɛ nhyehyɛe?
• So wubetumi akamfo akuw a wɔbɛboa nnipa a wɔwɔ asaabo mu yare a efi asikreyare mu akyerɛ?

Eyi ne nkrasɛm a ɛho hia sen biara a ɛsɛ sɛ mede ma wo...

Asaabo a asikreyare sɛe no yɛ tebea a emu yɛ den. Ebetumi akɔ so akodu asaabo a entumi nyɛ adwuma yiye, na ɛde nkwa to asiane mu. Sɛ wo duruyɛfo hu sɛ wowɔ asaabo mu yare a efi asikreyare mu a, ɛyɛ ade a ɛfata sɛ wobɛte ehu ne awerɛhow nka. Nanso, sɛ wunya yare no ntɛm na wudi w’ayaresa nhyehyɛe no akyi yiye a, wubetumi abrɛ asaabo mu yare a efi asikreyare mu no ase anaa mpo agyae.

Tebea a ɛte sɛɛ ho ayaresa a wubenya no betumi ayɛ nkate fam adwennwen. Nanso kae sɛ wo duruyɛfo wɔ hɔ sɛ ɔbɛboa wo. Ɔde ne ho ato so sɛ obebua wo nsɛmmisa nyinaa na waboa wo ma woakura w’asetra pa mu. Enti nsuro sɛ wo ne wo duruyɛfo bɛkasa afa biribiara a ɛwɔ w’adwenem ho.

` Asikreyare, Asaabo Yare, Asikreyare Asaabo Yare, DKD, Nephropathy, eGFR, Nsu mu Nhwehwɛmu, Nsu mu Nsuo mu Nhwehwɛmu