So eyi yɛ asiane ma w’asaabo nso? (Renal Papillary Necrosis) Momma yensua ho ade!

Wunim adwuma kɛse a asaabo nketewa abien a ɛwɔ yɛn nipadua mu no yɛ? Nokwarem no, asaabo no ne akwaa titiriw a ɛyi nneɛma fĩ fi mu na ɛtew mogya a ɛwɔ yɛn nipadua mu no ho. Nanso, ɛtɔ da bi a saa asaabo yi nso tumi nya nyarewa a yɛnhwɛ kwan. Ɛnnɛ yɛrebɛka tebea bi a ɛyɛ aniberesɛm kakra ho asɛm, nanso sɛ wunim a, ebetumi aboa wo ma woadi so na asiw ano.

Ɔkwan bɛn so na asaabo no yɛ adwuma? Dɛn ne Renal Papillary Necrosis a Ɛyɛ Fɛ?

Sɛ yɛbɛka no tiawa a, yɛn asaabo te sɛ super filter abien a ɛwɔ yɛn nipadua mu. Wɔn adwuma titiriw ne sɛ wobeyi nwura a wɔmpɛ a ɛwɔ mogya no mu no afi hɔ na wɔayi afi mu sɛ nsu. Nea ɛbɛyɛ na wɔatumi ayɛ eyi no, mogya kɔ asaabo no mu na ɛfa akwan nketenkete pii mu. Wɔboaboa saa nwura yi ano fi asaabo no akyi na afei ɛba asaabo no mfinimfini, a ɛyɛ asaabo no medulla . Afã horow a ɛte sɛ funnel ni. Saa nsukorade yi ano a wɔfrɛ no renal papilla no boaboa nsu ano. Efi hɔ no, nsu no fa nsukorabea ahorow no mu kɔ akisikuru no mu na efi adi. Saa na yɛn asaabo yɛ adwuma.

Renal papillary necrosis a yɛreka ho asɛm seesei no yɛ nkwammoaa ne ntini a ɛwɔ asaabo no mfinimfini fã (`Medulla`) ne renal papilla (`Renal Papilla`) a madi kan aka ho asɛm no wu. Susuw ho hwɛ, sɛ saa mmeae no ntumi nyɛ adwuma yiye a, adwuma a asaabo no yɛ no nyɛ adwuma yiye, ɛnte saa? Esiane eyi nti, asaabo no yɛ mmerɛw nkakrankakra, na awiei koraa no ebetumi ama asaabo no ayɛ adwuma yiye .

Hena na ɔwɔ asiane kɛse mu ma tebea yi?

Saa tebea yi (Renal Papillary Necrosis) taa ba nnipa a wɔadi boro mfe 60. Nnuruyɛfo nso kyerɛ sɛ mmea taa nya bi sen mmarima.

Dɛn ne nneɛma a ɛde Renal Papillary Necrosis ba?

Nneɛma atitiriw pii na ɛde saa yare yi ba. Momma yɛnhwɛ nea wɔyɛ.

• Asikreyare : Eyi ne ade biako pɛ a ɛho hia sen biara na ɛtaa de ba. Nnipa a asikreyare a wontumi nni so yiye no wɔ asiane kɛse mu sɛ wɔn asaabo bɛsɛe. Asikre dodow a ɛkɔ soro wɔ mogya mu bere tenten sɛe mogya ntini a ɛyɛ mmerɛw a ɛwɔ asaabo no mu no.
• Nnuru a wɔde kum ɛyaw a wɔde di dwuma boro so (NSAID) : Sɛ wotaa de nnuru a wɔde kum ɛyaw (nnuru a ɛnyɛ steroid a ɛko tia ɔyare mmoawa, anaa NSAID) te sɛ aspirin, ibuprofen, anaa naproxen di dwuma bere tenten a wonkɔ oduruyɛfo nkyɛn a, ɛsɛ sɛ wohwɛ yiye kɛse. Sɛ obi nom eyinom pii a, ebetumi ama mogya ntini a ɛwɔ asaabo no mu no ayɛ ketewaa na asɛe adwene no mu ntini no.
• Sickle Cell Yare a Ɛyɛ Fɛ: Eyi yɛ awosu mu yare. Wɔ saa yare yi mu no, mogya mu nkwammoaa kɔkɔɔ no nsɛso sesa na ebetumi akɔhyɛ mogya ntini no mu. Eyi nso betumi ama mogya a ɛkɔ asaabo no mu no asɛe (Renal Papillary Necrosis).

Wɔ nneɛma atitiriw a ɛde ba yi akyi no, tebea afoforo pii nso betumi ama Renal Papillary Necrosis aba:

• Mmerɛbo mu Yare a Enni Sabea
• Pyelonephritis, ɔyare mmoawa a ɛba asaabo mu (a ebetumi asɛe adwene no ntini no) .
• Renal Tuberculosis, yareɛ a ɛka asaabo a ɛwɔ ahurututu no akyi
• Renal Vein Thrombosis (mogya a ɛtwetwe wɔ ntini a ɛde mogya fi asaabo mu) .
• Ureteral Obstruction (sɛ nhwɛso no, esiane abo a ɛba nsu mu nti) .
• Vasculitis, mogya ntini a ɛyɛ hyew

Nea ɛho hia ne sɛ ɛnyɛ obiara a ɔwɔ saa nneɛma yi mu biako anaa nea ɛboro saa na obenya (Renal Papillary Necrosis). Nanso asiane a ɛwɔ mu no dɔɔso sen saa.

So eyi ka asaabo abien no nyinaa?

Yiw, wɔbɔ amanneɛ sɛ wɔ nnipa du biara mu bɛyɛ baason mu no , tebea yi (Renal Papillary Necrosis) ka asaabo abien no nyinaa .

Dɛn ne (Renal Papillary Necrosis) ho sɛnkyerɛnne?

Wɔ yare yi mfiase no, ebia na sɛnkyerɛnne biara nni hɔ . Ɛno nti na ɛyɛ den sɛ wubehu na woasa no ntɛm no. Fa no sɛ, wunni ɔhaw biara, nanso w’asaabo betumi asɛe afi wo mu. Nanso, ebetumi aba nso sɛ wohu eyi wɔ akwanhyia mu bere a wɔreyɛ yare foforo ho nhwehwɛmu no.

Nanso, sɛ tebea no (Renal Papillary Necrosis) mu yɛ den kɛse a, sɛnkyerɛnne ahorow te sɛ eyinom betumi ada adi:

• Nsu a ɛyɛ yaw (Dysuria) .
• Atiridiinini ne atiridiinini (titiriw sɛ ɔyare mmoawa bi ka ho a) .
• Mogya a ɛwɔ nsuo mu (`Hematuria`) - Mogya dodoɔ no bɛtumi de aniwa a ɛda hɔ ahunu (nsuo no bɛtumi adan kɔkɔɔ anaa bruu), anaasɛ ɛbɛtumi ayɛ ketewa araa ma wɔtumi hunu no wɔ microscope mu nko ara.
• Ɛho hia sɛ wɔtaa tow nsu anadwo (`Nocturia`) .
• Mogya mu nkwammoaa fitaa dodow a ɛkɔ soro a ɛnteɛ wɔ nsuo mu (`Pyuria`) - wei kyerɛ sɛ nsuo no betumi ayɛ te sɛ akisikuru, na nsuo no betumi ayɛ te sɛ mununkum.
• Ɛyaw a emu yɛ den wɔ akyi afã abien no nyinaa, mpampam ne asen nnompe ntam (baabi a asaabo no wɔ). Saa ɛyaw yi betumi aba mpofirim anaasɛ ɛde nkakrankakra akɔ soro.
• Nyarewa a ɛtaa ba wɔ nsu mu.

Ɔkwan bɛn so na wohu Renal Papillary Necrosis?

Nnuruyɛfo bɛyɛ nhwehwɛmu ahorow pii de ahu tebea yi (Renal Papillary Necrosis). Bere a wɔatie wo yare no ho sɛnkyerɛnne ne w’ayaresa ho abakɔsɛm awie no, wobetumi ahyɛ sɛ wɔnyɛ nhwehwɛmu te sɛ:

• Nsu mu nhwehwɛmu: Eyi hwehwɛ sɛ woyɛ w’asaabo X-ray, CT scan, anaa MRI. Ansa na wɔbɛyɛ sɔhwɛ no, wɔbɛma wo aduru soronko bi (aduru bi) afa ntini bi mu. Eyi boa ma wohu mmeae a asaabo no asɛe ne nsakrae a aba wɔ asaabo no mu no pefee.
• Ureteroscopy : Eyi hwehwɛ sɛ wɔde afiri a ɛyɛ tratraa a ɛyɛ mmerɛw (a mfoninitwa afiri wɔ n’awiei) fa nsu a wɔde fa nsu mu no mu de hwɛ akisikuru, akisikuru, ne asaabo no mu tẽẽ. Eyi ma wotumi hu sɛnea papillae no te pefee.
• Kidney Biopsy : Wɔ sɔhwɛ yi mu no, wɔde ade titiriw bi yi ntini ketewaa bi fi asaabo no mu na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu. Eyi betumi aboa ma wɔahu sɛ nkwammoaa awuwu anaasɛ ntini no asɛe.

Mogya ne nsu mu nhwehwɛmu

Bio nso, mogya ne nsu mu nhwehwɛmu a wɔbɛyɛ de ahwɛ sɛnea asaabo no yɛ adwuma nso ho hia yiye:

• Mogya mu urea nitrogen (BUN) nhwehwɛmu : Eyi kyerɛ urea nitrogen dodow a ɛwɔ mogya no mu. Eyi yɛ ade a wɔsɛe no. Saa dodow yi kɔ soro wɔ mogya no mu bere a asaabo no ntumi nyɛ adwuma yiye no.
• Creatinine sɔhwɛ : Creatinine yɛ ade foforo a wɔsɛe no bere a ntini ahorow no reyɛ adwuma sɛnea ɛsɛ. Mpɛn pii no, asaabo no na ɛyi fi mu. Sɛ ne dodow dɔɔso wɔ mogya no mu a, ɛkyerɛ nso sɛ asaabo no ntumi nyɛ adwuma yiye.
• Estimated Glomerular Filtration Rate (eGFR) : Wɔnam nneɛma te sɛ wo mogya mu creatinine dodow, mfe a woadi, ɔbarima anaa ɔbea, ne nipadua kɛse a wosusuw ho so na ebu eyi. eGFR bo no kyerɛ wo mogya dodow a w’asaabo yiyi simma biara. Dodow a saa bo yi sua no, dodow no ara na w’asaabo no ntumi nyɛ adwuma yiye.
• Nsuo mu nhwehwɛmu : Eyi hwehwɛ sɛ wɔfa nsuo bi na wɔde aniwa (kɔla, emu da hɔ), microscope (ma mogya mu nkwammoaa, akisikuru nkwammoaa, mmoawa, papillary debris), ne nnuru (ma protein, asikre) hwehwɛ mu. Ɛtɔ mmere bi a, wotumi hu adwene no mu ntini asinasin nso wɔ afiri a wɔde hwɛ nneɛma nketenkete mu.
• Protein/creatinine a ɛwɔ nsu mu : Eyi kyerɛ protein dodow a ɛwɔ nsu mu. Asaabo a ɛte apɔw no yi protein kakraa bi pɛ na ɛba. Protein a ɛdɔɔso wɔ nsu mu no yɛ sɛnkyerɛnne a ɛkyerɛ sɛ asaabo asɛe.

Dɛn ne nsɛnnennen a ebetumi afi (Renal Papillary Necrosis) mu aba?

Sɛ wɔansa saa tebea yi (Renal Papillary Necrosis) yiye a, tebea no betumi asɛe na ɛde nsɛnnennen a emu yɛ den aba.

• Asaabo mu Yare a Enni Sabea (CKD) : Esiane sɛ asaabo no sɛe bere nyinaa nti, wɔn dwumadi so tew nkakrankakra, na ɛde asaabo mu yare a enni sabea ba.
• Asaabo a Ɛnyɛ Den: Sɛ tebea no mu yɛ den a, asaabo no betumi ayɛ nea entumi nyɛ adwuma koraa, a ɛkyerɛ sɛ ebetumi abɛyɛ adwene no a entumi nyɛ adwuma yiye.
• Sɛ wobɛtena ase a, ebia ɛho behia sɛ wɔyɛ dialysis (wɔde afiri tew wo mogya ho) anaasɛ wɔde asaabo foforo ma .
• Wɔahu nso sɛ saa tebea yi ma asiane a ɛwɔ hɔ sɛ obi benya kokoram bi a wɔfrɛ no transitional cell cancer, a ɛba asaabo anaa ureter mu no yɛ kɛse.
• Asiane nso wɔ hɔ sɛ obi benya ɔyare mmoawa a emu yɛ den (sepsis).

Ɔkwan bɛn so na wɔsa Renal Papillary Necrosis?

Ayaresa pɔtee biara nni hɔ a wɔde sa Renal Papillary Necrosis. Ayaresa titiriw ne sɛ wɔbɛsa nea ɛde tebea no ba titiriw . Nhwɛsoɔ:

• Sɛ efi asikreyare a, ɛnde ɛho hia sɛ wodi asikreyare no so yiye.
• Sɛ efi NSAID a wɔde di dwuma nti a, gyae saa nnuru no nom.
• Sɛ efi ɔyare mmoawa bi a, ma no nnuru a ekum ɔyare mmoawa.
• Sɛ biribi asiw nsu a ɛkɔ nsu mu no mu a, ɛsɛ sɛ woyi fi hɔ.

Botae titiriw ne sɛ wɔbɛma asaabo no asɛe bio na wɔakora asaabo no dwumadi so sɛnea wobetumi biara.

Sɛnea ayaresa no bɛyɛ yiye no gyina baabi a asaabo no sɛe ne nea ɛde yare no ba no so. Wɔ tebea horow bi a emu yɛ den mu no, yare no betumi akɔ so asɛe ɛmfa ho ayaresa no. Nanso, wɔ nsɛm a emu nyɛ den pii mu, na sɛ wɔsa nea ɛde ba no ntɛm a, asaabo dwumadi betumi agyina anaasɛ atu mpɔn kakra mpo.

So metumi abɔ me ho ban afi Renal Papillary Necrosis ho?

Yiw, nneɛma bi wɔ hɔ a yebetumi ayɛ de abɔ yɛn ho ban afi tebea yi ho, wɔ ɔkwan kɛse so.

• Ade a ɛho hia sen biara ne sɛ wobɛkɔ so akura w'akwahosan nyinaa mu . Aduan a ɛkari pɛ a wubedi, nsu a ɛdɔɔso a wobɛnom, ne apɔw-mu-teɛteɛ daa ho hia.
• Sɛ worenom nnuru a wɔde kum ɛyaw a wɔtɔn (NSAID) a, fa di dwuma sɛnea wɔakyerɛ wɔ ade a wɔde ahyɛ mu no so anaasɛ sɛnea oduruyɛfo kyerɛ no nkutoo. Mma nnnom no mpɛn pii anaa nkyɛ nsen sɛnea ɛho hia. Mfa no daa wɔ ɛyaw ne ɛyaw nketenkete anaa tiyɛ ho.
• Sɛ wowɔ asikreyare (Diabetes Mellitus), sickle cell disease (Sickle Cell Disease), anaa nyarewa afoforo a ebetumi de asaabo mu yare (Renal Papillary Necrosis) aba a, di wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ. Kɔ ayaresabea ahorow wɔ bere ano. Fa nnuru a wɔakyerɛw ama wo no. Di aduan a ɛfata akyi.
• Ɛho hia yiye sɛ wobɛyɛ nhwehwɛmu wɔ lab de ahwɛ sɛnea asaabo no yɛ adwuma daa sɛnea wo duruyɛfo kyerɛ no, na woahu nsakrae biara ntɛm.

Sɛ obi a ɔwɔ saa yare yi ho tɔ no ahe?

Wo nkɔmhyɛ gyina nea ɛde yare no ba, baabi a asaabo no sɛe, w’akwahosan nyinaa, ne sɛnea wufi ase sa yare no ntɛmntɛm so.

• Wɔ nnipa a wɔwɔ asikreyare fam no, ebia nea ebefi mu aba no renyɛ papa kakra , efisɛ asikreyare yɛ yare a ɛtra hɔ kyɛ na ɛnyɛ bere nyinaa na wotumi di so yiye. Sɛ wowɔ asikreyare a, sɛ wudi so yiye sɛnea wubetumi a, ɛbɛboa kɛse ma woasiw asaabo a ɛsɛe no ano.
• Wɔ tebea horow a emu yɛ den mu (Renal Papillary Necrosis) no, ebetumi ama wɔayɛ dialysis ne asaabo foforo . Sɛ ɔyare mmoawa ba a, ebetumi de ne nkwa ato asiane mu. Owu betumi aba esiane asaabo a entumi nyɛ adwuma yiye nti.
• Wɔ sickle cell yare mu no, renal papillary necrosis yɛ nsɛnnennen pii a ebetumi aba wɔ asaabo mu no mu biako pɛ. Sɛ wɔka nsɛnnennen yi nyinaa bom a, wobetumi atew ɔyarefo no nkwa nna so kɛse.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, nsɛe bere na akyinnye biara nni ho sɛ wobɛkɔ oduruyɛfo nkyɛn :

• Sɛ mogya wɔ wo nsu mu (nsu dan kɔkɔɔ, pink, anaa bruu).
• Sɛ wowɔ atiridii anaa atiridiinini (titiriw bere a wowɔ sɛnkyerɛnne afoforo).
• Sɛ wote ɛyaw anaasɛ wo ho hyehye wo bere a woretow wo ho a.
• Sɛ wowɔ ɛyaw foforo anaasɛ ɛreyɛ kɛse wɔ w’akyi afã abien no nyinaa a, wɔ baabi a ɛda w’asen nnompe ne wo mpampam ntam (asaabo no fã).
• Sɛ wotaa nya ɔyare mmoawa a ɛba wo nsu mu a.
• Sɛ woretow nsu pii anaasɛ wo nan ne wo nansoaa ahonhon (eyinom betumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ asaabo no dwumadi so atew).

Kae sɛ, nyarewa afoforo nso betumi de saa sɛnkyerɛnne ahorow yi aba. Nanso, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn kɔhwɛ nea ɛde ba ankasa.

Awiei koraa no, nea ɛsɛ sɛ wokae (Take-Home Message) .

Yɛn asaabo yɛ akwaa a ɛho nhia ma yɛn nipadua, na ɛyɛ adwuma bi a ɛyɛ komm na ɛho hia. Wɔyi nneɛma a wɔsɛe no fi mu na wɔma nsu ne nkyene kari pɛ wɔ nipadua no mu. Asikreyare a wontumi nni so, nnuru a wɔde kum ɛyaw (NSAID) a wɔde di dwuma dodo, ne ayaresa mu tebea afoforo betumi asɛe asaabo no, na ɛde tebea horow a emu yɛ den te sɛ Renal Papillary Necrosis aba.

Ade a enye koraa wɔ saa yare yi ho ne sɛ ebia worennya sɛnkyerɛnne biara wɔ ne mfiase. Enti, sɛ wowɔ asikreyare, wotaa de NSAID di dwuma, anaasɛ wowɔ nneɛma afoforo a ɛde asaabo mu yare ba a, wo ne wo duruyɛfo nkasa mfa akwan a wobɛfa so abɔ w’asaabo ho ban ho asɛm. Ɛdenam nhwehwɛmu a wobɛkɔ akɔhwɛ wo daa na woadi asetra a ɛfata so no, wubetumi ama w’asaabo ayɛ yiye. Nhumu a wodi kan yɛ ne adeyɛ yɛ ade a eye sen biara a ɛsɛ sɛ woyɛ bere nyinaa.

` Asaabo, renal papillary necrosis, asaabo mu yare, asikreyare, NSAIDs, asaabo a entumi nyɛ adwuma yiye, nsu