So wowɔ phosphate dodow a ɛdɔɔso wɔ wo nipadua mu? Momma yɛnka hyperphosphatemia ho asɛm!

So woasusuw nea enti a ɛtɔ mmere bi a nneɛma bi a ɛwɔ yɛn nipadua mu korɔn sen sɛnea ɛsɛ sɛ ɛyɛ no ho pɛn? Ebia oduruyɛfo bi aka akyerɛ wo sɛ phosphate pii wɔ wo mogya mu. Anaasɛ ebia woate ho asɛm wɔ baabi. Eyi ne nea yɛfrɛ no hyperphosphatemia. Ɛwom sɛ ebia edin no bɛyɛ te sɛ nea ɛyɛ nwonwa kakra de, nanso sɛ yɛte ase yiye a, ɛnyɛ biribi a ɛsɛ sɛ yɛhaw yɛn ho.

Dɛn ankasa ne hyperphosphatemia?

Sɛ yɛbɛka no tiawa a, hyperphosphatemia yɛ bere a wo mogya mu aduru bi a wɔfrɛ no phosphate pii wom. Phosphate yɛ aduannuru a ɛho hia ma yɛn nipadua. Ɛboa ma yɛn nnompe ne yɛn sẽ yɛ den, ɛma yɛn nkwammoaa ahoɔden, na ɛboa ma yɛyɛ nkwammoaa mu ntini.

Susuw ho saa kwan yi so, phosphate te sɛ batere ketewaa bi a ɛwɔ yɛn nipadua mu. Sɛ eyinom betumi ayɛ adwuma yiye a, ɛsɛ sɛ wonya anyinam ahoɔden. Phosphate yɛ electrolyte a ɛte saa no mu biako . Electrolytes yɛ aboɔden abo a ebetumi agye anyinam ahoɔden a ɛyɛ papa (+) anaa bɔne (-) bere a wɔapete wɔ nsu anaa nsu te sɛ yɛn mogya mu no. Enti, phosphate dodow yi a wɔbɛma ayɛ pɛ no ho hia ma nipadua no dwumadi pii. So wote ase?

Hena na ɛda adi sɛ obenya saa tebea yi?

Nokwarem no, obiara betumi anya saa tebea yi a wɔfrɛ no hyperphosphatemia. Nanso, ɛtaa ba nnipa a wɔwɔ asaabo mu haw so. Ne titiriw no, nnipa a wɔwɔ asaabo mu yare a enni sabea (CKD) , titiriw wɔn a wɔwɔ yare a emu yɛ den, anaa wɔn a wɔn asaabo ntumi nyɛ adwuma yiye no, taa nya saa tebea yi.

Afei, nneɛma bi wɔ hɔ a ebetumi ama asaabo mu yare aba. Sɛ wowɔ nea edidi so yi mu biako anaa nea ɛboro saa a, asiane kakraa bi na ɛwɔ hɔ sɛ wubenya asaabo mu yare na ɛnam so anya hyperphosphatemia:

• Sɛ wowɔ asikreyare (Diabetes Mellitus) a .
• Sɛ wowɔ mogya mmoroso (hypertension) a .
• Sɛ wowɔ komayare a .
• Sɛ obi a ɔwɔ w’abusua mu anya asaabo mu yare (a ɛkyerɛ sɛ ebetumi ayɛ awosu mu yare).
• Sɛ biribi a ɛnteɛ wɔ w’asaabo nhyehyɛe mu a.
• Sɛ woyɛ Afrikani Amerikani, Hispanicni, Asiani, anaa Amerikafo Ankasa abusua mu a (nnipa a wɔwɔ mmusuakuw yi mu no taa nya asaabo mu yare).
• Sɛ woadi boro mfe 60 a .
• Sɛ wotaa de nnuru a ɛma ɛyaw ano brɛ ase di dwuma bere tenten a , titiriw nnuru a ɛnyɛ steroid a ɛko tia ɔyare mmoawa (NSAIDs), a wubetumi atɔ wɔ nnurutɔnbea hɔ wɔ aduruyɛdan mu.

Saa tebea yi abu so dɛn?

Sɛ wohwɛ nnipa dodow no ara a wɔwɔ wiase a, ɛntaa nsi koraa sɛ wubenya hyperphosphatemia nkutoo. Ɛno kyerɛ sɛ phosphate a ɛkɔ soro wɔ mogya no mu ara kwa. Nanso, sɛnea madi kan aka no, sɛ wowɔ asaabo mu yare a enni sabea , titiriw sɛ emu yɛ den a, tebea yi abu so kɛse. Sɛ yɛbɛka no tiawa a, wɔahu sɛ nnipa a wɔwɔ asaabo mu yare a emu yɛ den a enni sabea no mu bɛyɛ 70% wɔ hyperphosphatemia.

Sɛ phosphate dodow kɔ soro a, dɛn na ɛba nipadua no so?

Yɛadi kan aka sɛnea phosphate boa ma yɛn nnompe ne yɛn sẽ yɛ den, ɛma nkwammoaa nya ahoɔden, na ɛboa ma nkwammoaa mu ntini yɛ den no ho asɛm. Ɛno yɛ nokware. Nanso, te sɛ biribiara no, ɛdɔɔso dodo betumi de ɔhaw aba.

Fa no sɛ, sɛ phosphate dodow a ɛwɔ wo mogya mu no kɔ soro dodo a, efi ase yi calcium fi wo nnompe mu. Dɛn na ɛba saa bere no? Nnompe no yɛ mmerɛw na ɛyɛ mmerɛw.

Ɛnyɛ ɛno nko, na mmom saa phosphate a ɛboro so yi betumi ama calcium ayɛ w’ani, w’ahurututu, wo koma, ne wo mogya ntini mu. Eyi yɛ nea asiane wom kakra. Efisɛ bere kɔ so no, nneɛma a wɔde asie yi ma asiane a ɛwɔ hɔ sɛ wubenya komayare, akisikuru , ne owu mpo yɛ kɛse.

Dɛn ne Hyperphosphatemia ho sɛnkyerɛnne ahorow?

Mpɛn pii no, bere a wowɔ hyperphosphatemia nkutoo no, wunhu sɛnkyerɛnne atitiriw biara. Ɛno kyerɛ sɛ ebia mfiase no wunhu sɛ phosphate pii wɔ wo nipadua mu. Nanso, sɛnea yɛaka ho asɛm no, sɛ phosphate yi kɔ soro a, ebetumi ama calcium ayera afi wo nnompe ne wo mogya mu. Wɔfrɛ ɛno hypocalcemia . Ɛno kyerɛ sɛ calcium dodow a ɛwɔ mogya no mu no so tew.

Enti, mpɛn pii no, hyperphosphatemia ho sɛnkyerɛnne ne nea hypocalcemia de ba no yɛ pɛ. Hwɛ sɛ eyinom te sɛ nea wunim no yiye anaa:

• Ntini mu akisikuru.
• Nnadewa a ɛyɛ mmerɛw.
• Wora a ɛyɛ nwunu.
• Nwi a ɛyɛ mmerɛw sen wo ti nhwi a ɛte saa.
• Ɔhaw ahorow a ɛwɔ nkae mu .
• Abufuw a ɛma obi bo fuw.
• Anofafa, tɛkrɛma, nsateaa ano, ne/anaa anan mu a ɛyɛ mmerɛw.
• Ɛtɔ da bi a ɛba te sɛ akisikuru (akisikuru).
• Koma no bɔ a ɛnteɛ, kyerɛ sɛ, koma no bɔ a ɛnteɛ.

Dɛn nti na hyperphosphatemia ba?

Ebia nneɛma pii nti na ɛte saa. Wɔn titiriw ne:

• Asaabo mu yare a enni sabea a ɛkɔ anim. Eyi ne ade a ɛtaa de ba. Sɛ asaabo no ntumi nyɛ adwuma yiye a, entumi nyi phosphate a ɛboro so mfi nipadua no mu.
• Hypoparathyroidism a ɛma mogya tu. Eyi yɛ tebea a parathyroid ntini no nyɛ parathyroid hormone kakraa bi dodo, na ɛhwɛ nipadua no mu calcium ne phosphate dodow so.
• Wo mogya mu pH sua sen sɛnea ɛte daa (a ɛkyerɛ sɛ wo mogya no yɛ acidic kɛse). Ebia eyi te saa efisɛ w’ahurututu ntumi nyi mframa bɔne a ɛba wo nipadua mu no nyinaa mfi hɔ. Wɔfrɛ eyi sɛ ɔhome mu acidosis .
• Mogya mu pH a ɛso tew esiane nneɛma afoforo nti ( metabolic acidosis ).

Eyinom akyi no, ɛwom sɛ ɛntaa nsi de, nanso hyperphosphatemia nso betumi aba esiane nneɛma a edidi so yi nti:

• Ketoacidosis a ɛfa asikreyare ho.
• Ntini a ɛsɛe ( rhabdomyolysis ).
• Ɔyare mmoawa a emu yɛ den ( sepsis ).
• Crush injury (apirakuru a biribi a emu yɛ duru a ɛtɔ nipadua no so anaasɛ biribi a ɛmia nipadua no so bere tenten de ba).
• Wo nipadua no ntumi nyɛ adwuma yiye wɔ parathyroid hormone ( pseudohypoparathyroidism ) ho.
• Phosphate pii a wobɛkɔ wo nipadua mu, afi aduan a wudi mu anaasɛ ɛnam enema so .

Dɛn na ɛtaa de ba?

Sɛnea madi kan aka no, ade titiriw a ɛde hyperphosphatemia ba ne asaabo mu yare a enni sabea a ɛkɔ anim.

So eyi yɛ yare a wɔde kɔ nnipa mu?

Dabi, hyperphosphatemia nyɛ yare a ɛde ɔyare mmoawa ba. Worentumi ntrɛw mu mma afoforo. Nanso, ɛntaa nsi koraa sɛ ebetumi atu mmirika wɔ mmusua mu esiane awosu mu nneɛma nti.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Oduruyɛfo betumi ahu sɛ wowɔ hyperphosphatemia anaa. Ɔbɛfa w’aduruyɛ ho abakɔsɛm , ayɛ wo nipadua mu nhwehwɛmu , na wabisa wo yare no ho sɛnkyerɛnne, w’aduan, ne nnuru biara a wobɛnom ho asɛm. Sɛ wubehu phosphate dodow a ɛwɔ wo mu ankasa a, ɛho behia sɛ woyɛ wo mogya mu nhwehwɛmu .

Bere a wɔreyɛ mogya mu nhwehwɛmu no, oduruyɛfo anaa ɔyarehwɛfo de ade ketewaa bi (21 gauge, a ɛyɛ ketewaa kakra sen asomuade a wɔde di dwuma daa ano) begye mogya kakraa bi afi ntini bi a ɛwɔ wo nsa mu no mu. Wɔde mogya yi kɔ lab kɔhwɛ phosphate dodow a ɛwɔ wo mogya mu. Sɛ wo phosphate dodow boro miligram 4.5 wɔ mogya deciliter (4.5 mg/dL) biara mu a, ., ɛno kyerɛ sɛ wowɔ hyperphosphatemia.

Sɛ wohu sɛ wowɔ saa tebea yi a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu foforo mfa nhwɛ sɛnea w’asaabo te. Ebia eyinom bi ne:

• Mogya mu nhwehwɛmu foforo.
• Sɔhwɛ a wɔde hwɛ sɛ protein wɔ nsu mu anaa.
• Ultrasound scan a wɔde yɛ nhwehwɛmu.
• MRI scan a wɔde yɛ nhwehwɛmu.
• CT scan a wɔde yɛ adwuma.
• Kidney biopsy ( asaabo mu ntini ketewaa bi a wɔfa de yɛ nhwehwɛmu).

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Hyperphosphatemia ayaresa gyina nea ɛde phosphate a ɛdɔɔso wɔ wo mogya mu no so. Nnuan ne nnuru bi nso betumi ama phosphate dodow akɔ soro. Sɛ eyi ba a, ebia ebehia sɛ woto nnuan anaa nnuru bi a wudi ano hye anaasɛ wugyae koraa. Anaasɛ, ebia ebehia sɛ wodan kɔ aduru foforo a phosphate dodow sua so.

Nea ɛho hia sen biara ne sɛ wubedi oduruyɛfo no akwankyerɛ akyi pɛpɛɛpɛ.

Ebia wo duruyɛfo bɛkyerɛw nnuru a ɛtew phosphate dodow a wo nipadua no twe no so. Eyi kyerɛ sɛ phosphate pii fi wo nsu mu (pee). Nnuru yi bi ne:

• Sevelamer (Sɛvelamer - RenaGel®) .
• Lanthanum (Lanthanum - Fosrenol®) 1000. Ɔde ne nsa kyerɛɛ ne so.
• Calcium acetate (Kɔlsium aduru - Calphron®) .

Sɛ wo phosphate dodow dɔɔso esiane asaabo a entumi nyɛ adwuma yiye nti a, wo duruyɛfo betumi afi ase ayɛ wo dialysis . Dialysis yɛ nea ɛsɛ sɛ w’asaabo yɛ. Ɛne sɛ, eyi nsu ne nneɛma fĩ a ɛboro so, a phosphate ka ho, fi wo mogya mu.

Dɛn ne nnuan a phosphorus pii wom?

Nnuan ne anonne ahorow pii wɔ hɔ a phosphorus pii wom – ade a phosphate fi mu ba. Ɛho hia sɛ wuhu eyinom, titiriw sɛ wowɔ hyperphosphatemia a.

• Nufusu ne nufusu mu nneɛma te sɛ nufusu, kyiisi a wɔayɛ, ne yogurt.
• Nsã a carbon wom bi (soda pop/fizzy anonne).
• Nam a wɔayɛ ( te sɛ soseji ne bacon).
• Aduan a wɔde di ntɛmntɛm.
• Nnuan a wɔde di agoru ( nneɛma a wɔakyekyere te sɛ chips, biscuits).
• Nnuadewa.
• Whole grains , a nea ɛka ho ne awi, oats, ne aburow (titiriw nea wɔde bran ayɛ).
• Adua.
• Nnua a wɔfrɛ no lentils.

Ebia wo duruyɛfo no aka akyerɛ woWɔde wo bɛkɔ akɔma oduruyɛfo a ɔhwɛ adwene mu aduan ho ɔbenfo . Eyinom yɛ nnipa a wɔn ho akokwaw wɔ sɛnea wobɛhwɛ w’aduan so de aboa asaabo akwahosan ho. Wɔbɛboa wo ma woayɛ aduan ho nhyehyɛe titiriw bi (renal diet) a ɛto phosphate dodow a ɛwɔ wo nipadua mu no ano hye.

So ɔkwan bi wɔ hɔ a wobɛfa so aguan tebea yi?

Ɔkwan pa a wobɛfa so asiw hyperphosphatemia ano ne sɛ wobɛhwɛ w’asaabo akwahosan so na woahu phosphate ne calcium dodow a woredi. Sɛ wususuw sɛ ebia wobɛkɔ asiane mu ama tebea yi a, wo ne wo duruyɛfo nkasa. Ebia ɔde wo bɛkɔ oduruyɛfo a ɔhwɛ ahurututu mu yare nkyɛn . Nephrologist yɛ oduruyɛfo a ne ho akokwaw wɔ tebea horow a ɛka asaabo ho.

Mmere bɛn na eye sen biara a wubetumi akɔ oduruyɛfo nkyɛn?

Sɛ wunim sɛ wowɔ hyperphosphatemia, na wunya asaabo mu yare anaa asaabo a entumi nyɛ adwuma yiye ho sɛnkyerɛnne a, kɔ oduruyɛfo nkyɛn ntɛm ara. Ntwentwɛn wo nan ase.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo?

Sɛ wokɔ oduruyɛfo nkyɛn a, ɛho hia yiye sɛ wubisa nsɛm yi:

• Wobɛyɛ dɛn ahu no yiye sɛ mewɔ hyperphosphatemia?
• Sɛ minni saa tebea yi a, aduruyɛ mu tebea afoforo bɛn na metumi anya?
• Dɛn ne mogya mu phosphate dodow a ɛfata?
• Nnuru bɛn na wokamfo kyerɛ me?
• So wuhia krataa a wɔkyerɛw ma wo ansa na woanya saa aduru no, anaasɛ wubetumi atɔ wɔ nnurutɔnbea hɔ ara kwa?
• Nnuan ne anonne bɛn na ɛnsɛ sɛ midi anaa menom?
• Phosphorus dodow ahe na ɛsɛ sɛ midi da biara?
• So wubetumi de me akɔma obi a ɔyɛ adwene mu aduan ho ɔbenfo?
• So ɛsɛ sɛ mekɔ nephrologist anaa ɔbenfo foforo nkyɛn?

Nsonsonoe bɛn na ɛda Hyperphosphatemia ne Hypocalcemia ntam?

Saa abien yi betumi ayɛ basaa kakra, enti momma yɛnma emu nna hɔ.

Hyperphosphatemia yɛ bere a phosphate dodow a ɛwɔ wo mogya mu no dɔɔso dodo .

Hypocalcemia yɛ bere a calcium dodow a ɛwɔ wo mogya mu no so tew dodo .

Mpɛn pii no, saa tebea a wɔfrɛ no hypocalcemia yi ba sɛ aduruyɛ mu tebea foforo bi mu nsunsuanso bɔne. Hyperphosphatemia yɛ ade biako a ɛde hypocalcemia ba.

Nkrasɛm a Etwa To a Wɔde Kɔ Fie

Okay, enti yɛaka hyperphosphatemia ho asɛm pii. Sɛ yɛbɛka no tiawa a, ɛyɛ phosphate dodow a ɛkɔ soro wɔ wo mogya mu. Bere a ɛnyɛ nea abu so kɛse wɔ nnipa dodow no ara mu wɔ wiase no, ebetumi abu so kɛse wɔ nnipa a wɔwɔ asaabo mu yare a enni sabea anaa asaabo a entumi nyɛ adwuma yiye mu .

Mpɛn pii no, mfiase no, sɛnkyerɛnne pɔtee biara nni hɔ. Enti, nnipa pii hu sɛ wɔwɔ tebea no bere a sɛnkyerɛnne afoforo ada adi akyi nkutoo, ebia te sɛ hypocalcemia.

Sɛ wuhu sɛ wowɔ hyperphosphatemia, titiriw bere a wɔka kyerɛ wo sɛ wuhia dialysis a, ɛyɛ ade a ɛfata sɛ wobɛte dadwen ne ehu nka. Mfomso biara nni ho sɛ yebenya saa nkate no. Wo ne wo duruyɛfo nkasa mfa nsɛmmisa anaa nsɛm biara a ɛhaw wo ho. Wɔbɛma wo nsɛmmisa ho mmuae, ama wo mmoa a wuhia, na wɔama wo afotu wɔ sɛnea wubetumi agyina tebea yi ano yiye ho. Kae sɛ ɛnyɛ wo nko ara!

` Hyperphosphatemia, Phosphate, Asaabo mu yare, Asaabo mu yare a enni sabea, Hypocalcemia, Dialysis