So sukɔm de wo nso bere nyinaa na woto nsu pii? Momma yɛnka Nephrogenic Diabetes Insipidus ho asɛm.

So sukɔm de wo nso da mũ nyinaa? Ɛmfa ho nsu dodow a wobɛnom no, woda so ara te nka sɛ wunni nea ɛdɔɔso? So ɛho hia nso sɛ wotaa tow wo ho mpɛn pii na wototo wo ho? Ebia wubesusuw sɛ eyi yɛ ade a ɛfata, anaasɛ wubesusuw mpo sɛ ɛyɛ asikreyare. Nanso, eyi nso betumi ayɛ aduruyɛ mu tebea bi a ɛntaa nsi a wɔfrɛ no ‘Nephrogenic Diabetes Insipidus’ ho sɛnkyerɛnne. Momma yɛnka eyi ho asɛm tiawa, wɔ ɔkwan a wubetumi ate ase so.

Dɛn ne Nephrogenic Diabetes Insipidus?

Sɛ yɛbɛka no tiawa a, nephrogenic diabetes insipidus yɛ tebea a w’asaabo ntumi nhwɛ nsu dodow a ɛwɔ wo nipadua mu no yiye. Yɛn nipadua no yɛ hormone bi a wɔfrɛ no Antidiuretic Hormone, anaa ADH tiawa. Nnipa binom nso frɛ no Vasopressin. Saa hormone yi, ADH, "kyerɛ" yɛn asaabo nsu dodow a ɛsɛ sɛ yi fi nsu mu ne dodow a ɛsɛ sɛ ɛkora so wɔ nipadua no mu.

Obi a ɔwɔ nephrogenic diabetes insipidus asaabo ntumi nyɛ adwuma yiye wɔ ADH hormone yi ho. Ɛne sɛ, ɛwom mpo sɛ ADH hormone no ma sɛnkyerɛnne bi sɛ "ɛkora nsu so na ɛtew nsu so" de, nanso asaabo no ntie. Nea ɛba saa bere no ne sɛ asaabo no ma nsu pii sen sɛnea ɛho hia. Eyi betumi ama nsu ho atɔ no ntɛmntɛm, ɛtɔ mmere bi a asiane wom, kyerɛ sɛ nsu a enni nipadua no mu.

Saa tebea yi abu so dɛn?

Nyansahufo nnim nnipa dodow a wɔwɔ asikreyare a ɛma obi nya nephrogenic diabetes insipidus ankasa, nanso wogye di sɛ ɛyɛ tebea a ɛntaa nsi koraa . Ɛno kyerɛ sɛ ɛnyɛ yareɛ a obiara nya.

So Asikreyare a Ɛnyɛ Den no ahorow wɔ hɔ?

Yiw, asikreyare ahorow anan na ɛwɔ hɔ a ɛnyɛ dɛ. Ma yɛnhwɛ nea wɔyɛ:

• Central Diabetes Insipidus: Eyi ba bere a pituitary gland anaa hypothalamus asɛe w’amemene no. Eyinom ne afã horow a ɛma ADH hormone no yɛ, ɛkora so, na eyi fi mu. Saa ɔsɛe yi mma nipadua no ntumi nhwɛ ADH so sɛnea ɛsɛ.
• Nephrogenic Diabetes Insipidus: Wɔ asikreyare a yɛreka ho asɛm nnɛ yi mu no, asaabo no ntumi nyɛ adwuma yiye wɔ ADH hormone no ho. Ɛwom mpo sɛ ADH hormone no wɔ hɔ de, nanso ɛte sɛ nea asaabo no bu wɔn ani gu so.
• Dipsogenic Diabetes Insipidus: Wɔsan frɛ no ‘Primary Polydipsia’, eyi fi sintɔ bi a ɛwɔ sukɔm ano aduru a ɛwɔ wo hypothalamus mu. Eyi ma wote nka sɛ sukɔm de wo kɛse, wote nka sɛ ɛho hia sɛ wotaa nom nsu , na wotow wo ho boro so.
• Gestational Diabetes Insipidus: Eyi ba bere a wɔyem nkutoo. Ɛtɔ mmere bi a, enzyme bi a awotwaa no yɛ no sɛe ADH hormone no. Eyi kɔ bere a wɔawo akokoaa no akyi.

Nsonsonoe bɛn na ɛda Nephrogenic Diabetes Insipidus ne Asikreyare Mellitus ntam?

Eyi yɛ asɛm a ɛho hia paa a nnipa pii adwene tu fra wɔ ho. Sɛ yɛte asɛmfua "asikreyare" a, yɛdwen asikre a ɛkyerɛ asikreyare ho. Nanso, ɛwom sɛ asikreyare a ɛma obi nya nephrogenic diabetes insipidus ne asikreyare a ɛma obi ho yɛ hyew (te sɛ nsu a wɔtow boro so ne sukɔm dodo) ho sɛnkyerɛnne ahorow bi yɛ pɛ de, nanso ɛsono saa nyarewa abien yi koraa.

Asikreyare yɛ yare a abu so kɛse. Ɛfiri insulin hormone a enni nipadua no mu anaasɛ nipadua no mfa insulin nni dwuma yiye, na ɛma asikre dodow kɔ soro wɔ mogya mu. Nanso, asikreyare a ɛma obi nya nephrogenic diabetes insipidus yɛ ɔhaw a ɛba bere a asaabo no ntumi nyɛ ADH hormone no ho hwee na ɛne asikre dodow a ɛwɔ mogya mu nni hwee yɛ no . Enti, eye sɛ woremfa abien no nfrafra, ɛnte saa?

Dɛn ne nneɛma a ɛde Nephrogenic Diabetes Insipidus ba?

Yɛn asaabo na ɛhwɛ mogya mu na eyi nwura ne nsu a ɛboro so fi nipadua no mu sɛ nsu. Hormone ADH (vasopressin) boa ma nsu dodow a yɛnom ne nsu dodow a yeyi fi mu no kari pɛ.

Fa no sɛ, sɛ obi a ɔwɔ apɔwmuden ho fifiri pii anaasɛ ɔnom nsu pii a, ADH dodow kɔ soro, na ɛka kyerɛ asaabo no sɛ ‘wɔmma nsu pii nkɔ, nkora nsu so wɔ nipadua no mu.’ Saa ara nso na sɛ nsu a ɛdɔɔso wɔ nipadua no mu a, ADH dodow so tew, na ɛka kyerɛ asaabo no sɛ ‘ɛnyɛ hwee, yɛ nsu kɛkɛ mprempren.’

Nanso, sɛ wo nipadua no ntumi nyɛ ADH ho adwuma yiye a, w’asaabo no ma nsu pii ba. Eyi ne nea ɛkɔ so wɔ asikreyare a ɛma obi nya nephrogenic insipidus mu. Saa tebea yi betumi afi awo mu (agyapade) anaasɛ ebetumi aba bere biara wɔ w’asetra mu (wɔanya) .

Asikreyare a ɛma obi nya nephrogenic insipidus

Eyi ne ɔkwan a wɔtaa de di dwuma. Ɛba bere a biribi siw nipadua no kwan sɛ ɛbɛyɛ ADH ho biribi no. Sɛ nhwɛso no, ebetumi afi tebea horow bi a ɛka w’asaabo. Tebea horow a ɛtete saa no bi ne:

• Amyloidosis – Eyi ne bere a protein a ɛnyɛ ne kwan so de gu akwaa ahorow a asaabo ka ho mu.
• Kokoram ahorow bi
• Asaabo mu yare a enni sabea
• Asaabo mu yare, sɛ nhwɛso no, pyelonephritis
• Polycystic kidney disease – Eyi ne bere a cysts a nsu ahyɛ mu ma ba wɔ asaabo no mu.
• Medullary sponge asaabo a ɛwɔ nipadua no mu

Nneɛma afoforo nso wɔ hɔ a ɛka eyi:

• Nnuru bi: Titiriw lithium (a wɔde di dwuma ma adwenemyare bi) bere a wɔde di dwuma bere tenten no.
• Potassium dodow a ɛba fam wɔ mogya mu (hypokalemia) .
• Calcium dodow a ɛkɔ soro wɔ mogya mu (hypercalcemia) .
• Sickle cell mogya a ɛtɔ kɔ nipadua mu
• Sjögren’s syndrome – Eyi yɛ yare a ɛma nipadua no tumi ko tia nyarewa.
• Nsuo kwan a ɛsiw – sɛ nhwɛsoɔ no, biribi te sɛ nsuo mu ɔbo.

Asikreyare a efi awosu mu a ɛma obi nya nephrogenic

Eyi fi nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm AVPR2 anaa AQP2 mu. Saa awosu mu nkwaadɔm yi ma nipadua no kyerɛ nsu dodow a ɛsɛ sɛ ɛde ka nsu no ho. Sɛ saa awosu mu nkwaadɔm yi di dɛm a, asaabo no ntumi nyɛ adwuma wɔ ADH ho. Asikreyare a ɛma obi nya nephrogenic diabetes insipidus a efi awo mu no taa da adi wɔ asram kakraa a edi kan wɔ nkwa nna mu .

Dɛn ne Nephrogenic Diabetes Insipidus ho sɛnkyerɛnne ahorow?

Fa no sɛ, wunim obi, ma yɛnka sɛ Sumana. Sumana sukɔm de no ma ɛyɛ nwonwa da mũ nyinaa. Ɔde nsu toa kɛse bi a ɛbɛn hɔ na ɛyɛ adwuma. Nanso wɔ dɔnhwerew biako akyi bere a wanom nsa no, sukɔm de no bio, na ɛsɛ sɛ ɔtaa kɔ tiafi nso, na ɔtow ne ho pii. Ɛtɔ da bi a, ɔsɔre mprenu anaa mprɛnsa anadwo biara kɔtow nsu. Osusuwii sɛ, ‘Ebia ɛyɛ nea menom nsu pii nti.’ Nanso eyinom ne asikreyare a ɛma obi nya nephrogenic insipidus ho sɛnkyerɛnne atitiriw.

Obi a ɔwɔ nephrogenic diabetes insipidus betumi anya sɛnkyerɛnne ahorow te sɛ:

• Nsɛnkyerɛnne a ɛkyerɛ sɛ nsu ho ayɛ no hyew: Ano a ɛyɛ nwunu, anofafa a ɛpaapae, ɔbrɛ a ɛtra so, te nka sɛ ne ti ayɛ no yaw, na ɛtɔ mmere bi a n’ani yɛ bruu bere a ogyina hɔ no. Fa no sɛ ɛte sɛ nea wowɔ owia mu bere tenten a nsu nni mu.
• Polydipsia: Te a wobɛte nka sɛ wunnya nsu a ɛdɔɔso ɛmfa ho sɛnea wobɛnom no.
• Nsu a wɔtow boro so (Polyuria): Sɛ ɔpanyin bi tow boro lita 3 da biara (mpɛn pii no ɛyɛ lita 5-20!), na sɛ abofra tow boro lita 2 da biara a, ɛyɛ adwenem naayɛ. Nsu no nso kɔla yɛ hare yiye, te sɛ nsu.

Sɛ akokoaa kumaa bi wɔ saa tebea yi a, ebia ɔbɛda yare no ho sɛnkyerɛnne te sɛ eyi adi efisɛ wɔnte sɛnea wɔkasa ase:

• Ayamtuo
• Sɛ obi ntumi nnya nkɔso na wo mu duru nkɔ soro – Ɛnyɛ sɛ wo mu duru nkɔ soro anaasɛ worenkɔ soro te sɛ nkokoaa afoforo.
• Atiridiinini a ɛtaa ba
• Ahomegye ne osu a ɛkɔ so daa (Irritability) – ɛte sɛ nea akokoaa no wɔ ahokyere mu.
• Aduan ho akɔnnɔ a ɛyera, nufusu a wɔnom so tew
• Seizures – Eyi yɛ sɛnkyerɛnne a ɛyɛ hu.
• Ɔfe a wɔfe
• Ɛsɛ sɛ wɔtaa sesa mpaboa a ɛyɛ nsu.

Ɔkwan bɛn so na wohu sɛ obi anya Nephrogenic Diabetes Insipidus?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wobɛkɔ oduruyɛfo nkyɛn. Obebisa wo nsɛm, ahwehwɛ wo mu, na sɛ ɛho hia a, ɔkra sɔhwɛ ahorow te sɛ:

• Mogya mu nhwehwɛmu: Hwɛ sɛnea electrolytes te sɛ sodium wɔ nipadua no mu, ne sɛnea asaabo no yɛ adwuma.
• Nsu mu nhwehwɛmu:Hwɛ sɛnea nsu no mu duru (sɛnea ɛyɛ mmerɛw), ne nea ɛwɔ nsu no mu.
• Nsu a wonnya ho sɔhwɛ: Nea ɛka eyi ho ne sɛ worennom nsu biara nnɔnhwerew pii, na afei wobɛhwɛ wo mu duru, wo nsu a ɛba, ne mogya ne wo nsu dodow so dɔnhwerew biara. Eyi yɛ sɔhwɛ a ɛyɛ den, nanso ɛho hia yiye na ama wɔahu yare no. Eyi nkutoo ne ɔkwan a wɔbɛfa so ahu pɛpɛɛpɛ sɛ ebia asaabo no reyɛ wɔn ade wɔ ADH ho anaa. Wɔyɛ sɔhwɛ yi wɔ aduruyɛfo hwɛ ase wɔ ayaresabea.
• ADH hormone a wɔde sɔ hwɛ: Ɛtɔ mmere bi a, wɔde ADH hormone ma sɛ aduru a wɔde twitwiw nipadua no mu ka nsu a wonnya ho sɔhwɛ no ho, na afei wɔhwɛ sɛ ebia nsu no dodow sesa anaa. Wɔ nephrogenic diabetes insipidus mu no, sɛ wɔde ADH ma mpo a, nsu mu dodow nsakra kɛse.
• MRI scan of your pituitary gland (Magnetic resonance imaging): Sɛ wususuw sɛ tebea bi te sɛ asikreyare a enni mu wɔ mfinimfini a, hwehwɛ biribiara a ɛnteɛ wɔ amemene no mu.
• Awosu mu nhwehwɛmu: Sɛ obi wɔ w’abusua mu asikreyare a ɛnyɛ dɛ, anaasɛ wususuw sɛ ɛyɛ asikreyare a wonya fi awo mu a.

So aduru bi wɔ hɔ a edi mũ a wɔde sa Nephrogenic Diabetes Insipidus?

Sɛ yɛbɛka nokware a, mprempren wonni asikreyare a ɛma obi nya nephrogenic insipidus aduru koraa.

Nanso mma ɛnhaw wo. Wobetumi adi ho dwuma. Ebia wo duruyɛfo betumi asesa nnuru a worenom a ɛde ɔhaw no reba (te sɛ lithium). Afei nso, sɛ tebea foforo bi wɔ hɔ a ɛde ba (te sɛ asaabo mu yare anaasɛ calcium/potassium a ɛnkari pɛ) a, ɛtɔ mmere bi a sɛ wɔsa no yiye a, ebetumi adan asikreyare a ɛma obi nya nephrogenic insipidus anaasɛ asiw ano.

Enti wodi eyi ho dwuma dɛn?

Wɔ nsɛm a wontumi nsakra (sɛ nhwɛso no, awo mu) mu no, ayaresa no atirimpɔw titiriw ne sɛ wobesiw nsu a ɛho ayɛ fĩ ano na wɔakura asetra pa mu. Eyi betumi ayɛ:

• Nom nsu daa: Eyi ne ade a ɛho hia sen biara. Ɛsɛ sɛ wonom nsu da mũ no nyinaa, bere biara a wote nka sɛ sukɔm de wo. Hwɛ hu sɛ wobɛnom nsu pii, titiriw nna a ɛyɛ hyew, bere a woreyɛ apɔw-mu-teɛteɛ, anaa bere a wo ho fifiri retu wo. Fa nsu toa bi sie baabi a ɛbɛn wo anadwo, nso.
• Nsakrae a ɛba wɔ aduan mu:
• Aduan a nkyene nnim: Sɛ wodi nkyene pii a, ɛma sukɔm ne nsu a wɔtow no yɛ kɛse.
• Aduan a protein nnim: Ɛtɔ mmere bi a wobetumi aka akyerɛ wo sɛ to protein ano hye, efisɛ nsu nso ho hia na ama wɔahohoro nneɛma fĩ a ɛba bere a protein di mu no.
• Nnuru a ɛtew nsu a ɛba nipadua mu no so:
• Thiazide nnuru a wɔde yi nsu fi nipadua mu:Nea ɛyɛ nwonwa no, sɛ wɔde nnuru a ɛma nsu fi nipadua mu yi ma nnipa a wɔwɔ asikreyare a ɛma obi ho yɛ hyew a, ɛtew nsu dodow a ɛba no so ankasa. Ɛyɛ den kakra, nanso mfaso wɔ so.
• Amiloride: Wobetumi de aka thiazides ho, titiriw wɔ NDI a lithium de ba no ho.
• Nnuru a Wɔde Ma a Ɛnyɛ steroid a Ɛko Tia Ɔhaw (NSAIDs): Sɛ nhwɛso no, indomethacin. Eyinom boa ma asaabo no yɛ mmerɛw kakra wɔ ADH ho.

Nnuan ne anonne bɛn na ɛsɛ sɛ obi a ɔwɔ saa tebea yi kwati?

Ebia wo duruyɛfo bɛka akyerɛ wo sɛ to nsa, anonne a caffeine wom (te sɛ kɔfe, tii, ne anonne a ɛyɛ dɛ bi), nnuan a nkyene wom (te sɛ akutu, nam a ayow, soseji, ne chips), ne ebia nnuan a protein pii wom ano hye, efisɛ eyinom betumi ama wo nipadua no ahwere nsu pii na nsu a wonom no ayɛ kɛse.

So akwan bi wɔ hɔ a wɔfa so siw Nephrogenic Diabetes Insipidus ano?

Akwan biara nni hɔ a wɔada no adi sɛ wɔbɛfa so asiw eyi ano. Titiriw no, wontumi nsiw nea wonya fi awo mu no ano. Nanso, wɔ ɔkwan a wɔanya no fam no:

• Sɛ worenom nnuru a ebetumi de NDI aba te sɛ lithium a, ɛho hia sɛ wo ne wo duruyɛfo kasa fa ho na wɔma wɔhwɛ w’asaabo dwumadi mu daa.
• Wobetumi atew asiane no so denam akwahosan ho haw ahorow a ɛda adi (asaabo mu yare, electrolyte a ɛnkari pɛ) a wɔbɛsa ntɛm ara na wɔayɛ no yiye so.

Sɛ mewɔ saa tebea yi a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Eyi ne asɛmpa a eye sen biara. Sɛ wɔsa wɔn yare yiye na wonya asetra pa a , mpɛn pii no, nnipa a wɔwɔ asikreyare a ɛma obi nya nephrogenic diabetes insipidus no nnya nsɛnnennen atitiriw pii na wotumi tra ase sɛnea ɛsɛ. Wubetumi ayɛ adwuma na w’ani agye asetra mu sɛnea wotaa yɛ no.

Nanso, sɛ wɔanni ho dwuma yiye a, eyi betumi de nsɛnnennen a emu yɛ den aba. Momma yɛnhwɛ nea wɔyɛ:

• Nsu a ɛtɔ: Eyi ne ɔhaw a ɛtaa ba na ɛyɛ hu sen biara. Nsu a ɛho tew kɛse betumi ama n’adwene atu afra, akisikuru, ne asaabo a entumi nyɛ adwuma yiye.
• Electrolyte disturbance: Eyi yɛ nsakrae a ɛba electrolytes (te sɛ sodium ne potassium) dodow a ɛwɔ nipadua no mu. Eyi betumi aka koma a ɛbɔ ne ntini ahorow no dwumadi.
• Nyarewa: Nneɛma te sɛ Urinary Tract Infections (UTI) ne asaabo mu yare.
• Nkɔso a ɛkyɛ, amemene a ɛsɛe ne adwene mu dɛmdi wɔ nkokoaa mu. Eyi yɛ asiane kɛse ma mmofra nkumaa. Enti, sɛ akokoaa bi wɔ saa sɛnkyerɛnne ahorow yi a, ɛsɛ sɛ wofi ase sa yare no ntɛm ara.
• Asaabo a entumi nyɛ adwuma yiye: Ebetumi aba bere tenten sɛ wɔanhyɛ so yiye a.
• Hydronephrosis: Esiane sɛ akisikuru no yɛ ma bere nyinaa nti, nsu no san kɔ akyi na asaabo no hohoro.

Bere bɛn na ɛsɛ sɛ wohwehwɛ aduruyɛ mu afotu?

Sɛ w’adwene mu yɛ wo naa anaasɛ wohaw wo ho wɔ nsu dodow a worefa mu ho, titiriw sɛ woretow nsu pii a woretow boro so a, akyinnye biara nni ho sɛ kɔ oduruyɛfo nkyɛn.

Nsu dodow a ɔpanyin de fa mu da biara no betumi ayɛ soronko wɔ onipa biara ho, titiriw no, egyina nsu dodow a ɔnom so. Nanso sɛ woretow bɛboro lita 2-3 da biara (nkyerɛase ahorow bi ka sɛ ɛboro lita 3), anaasɛ wotaa tow wo ho kɛse (bɛboro mpɛn ason anaa awotwe da biara) , ebetumi ayɛ ɔhaw bi ho sɛnkyerɛnne.

Ansa na wobɛkɔ oduruyɛfo nkyɛn no, ɛboa kɛse sɛ wobɛkyerɛw nsu dodow a wonom ne nsu dodow a woyɛ (sɛ ɛbɛyɛ yiye a, wobɛsusuw). Eyi bɛma ayɛ mmerɛw ama oduruyɛfo no sɛ ɔbɛte wo tebea no ase.

Enti, nneɛma bɛn na ɛsɛ sɛ yɛkae fi saa asɛm yi mu? (Nkrasɛm a Wɔde Kɔ Fie)

Nephrogenic Diabetes Insipidus yɛ tebea a ɛntaa nsi a w’asaabo ntumi nyɛ hormone ADH a ɛwɔ wo nipadua mu no ho dwuma yiye, na ɛma wo nsu pii. Eyi betumi ama nsu ho atɔ no ntɛmntɛm.

• Nsɛnkyerɛnne titiriw ne sukɔm a ɛboro so ne nsu a wɔtow boro so a nsu wom .
• Ɛnsɛ sɛ wɔde eyi fra asikreyare; wɔ eyi mu no, asikre dodow a ɛwɔ mogya mu no yɛ nea ɛfata.
• Saa tebea yi betumi aba bere a wɔawo no anaasɛ ɛbɛba akyiri yi wɔ n’asetra mu.
• Ɛwom sɛ aduru biara nni hɔ a edi mũ de, nanso sɛ wonya ayaresa a ɛfata ne asetra mu nsakrae (titiriw nom nsu a ɛdɔɔso na wohwɛ w’aduan so) a, wubetumi atra ase sɛnea ɛsɛ na apɔwmuden wom.
• Sɛ wususuw sɛ wo anaa wo ba no wɔ saa sɛnkyerɛnne ahorow yi bi a, hwehwɛ aduruyɛfo afotu ntɛm ara. Mma wo ho nnpopo, nanso nea ɛho hia sen biara ne sɛ wobɛbɔ wo amanneɛ na woatu anammɔn a ɛho hia. Ɛnyɛ wo nko ara, na nnuruyɛfo betumi aboa wo.

` Nephrogenic asikreyare insipidus, asaabo mu yare, nsu a wɔtow boro so, sukɔm a ɛboro so, ADH, vasopressin, nsu a ɛtɔ