Momma yɛnka nyarewa a ɛka asaabo no mu ne akyi fã (Renal Parenchymal Disease) ho asɛm kɛkɛ!

Asaabo a ɛwɔ yɛn nipadua mu no te sɛ adwumayɛfo a wɔyɛ komm, ɛnte saa? Wɔyɛ adwuma pii a yennim mpo. Wɔhohoro yɛn mogya ho da mũ nyinaa, wɔhwɛ nsu dodow a ɛwɔ nipadua no mu so, na woyi nneɛma fĩ a ɛho nhia fi hɔ. Nanso ɛtɔ da bi a, saa asaabo yi nso wɔ ɔhaw ahorow. Ɛnnɛ yɛrebɛka yareɛ bi a ɛka asaabo a ɛte saa ho asɛm. Ɛno ne renal parenchymal disease, anaasɛ wɔ Borɔfo kasa mu no `(Renal Parenchymal Disease)` . Ebia edin yi bɛyɛ te sɛ nea ɛyɛ den kakra bere a wote no, nanso momma yɛnte ase kɛkɛ.

Dɛn ne Renal Parenchymal Yare?

Sɛ yɛbɛka no tiawa a, eyi yɛ tebea horow kuw bi a ɛsɛe asaabo no. Ɛka asaabo no fã a wɔfrɛ no ``Parenchyma'' titiriw. Afei ebia woresusuw nea ɛyɛ parenchyma yi ho. Ɛne sɛ, asaabo no afã atitiriw a ɛyɛ adwuma, anaasɛ ɛboa ma asaabo no yɛ adwuma. Saa parenchyma yi wɔ afã atitiriw abien:

1. Renal Cortex : Eyi ne asaabo no akyi fã kɛse. Nneɛma nketenkete a ɛtwetwe nneɛma a ɛwɔ yɛn asaabo mu a wɔfrɛ no nephrons , no fi ase wɔ ha. Saa nephron ahorow yi te sɛ nneɛma nketenkete a wɔde yiyi mu. Wɔwɔ afã abien. Biako ne mogya ntini bi a wɔfrɛ no glomerulus . Ɔfoforo no yɛ afiri ketewaa bi a wɔfrɛ no renal tubule .

• Wɔde glomeruli no di kan yi mogya no mu .
• Adwene mu ntini no dwumadi ne sɛ ɛsan twetwe nsu, aduannuru, ne nneɛma a nipadua no hia na ɛde nwura a ɛho nhia fa nsu mu fi mu.
• Bio nso, asaabo mu ntini no nso yɛ hormone bi a wɔfrɛ no `Erythropoietin (EPO) .` Saa `(EPO)` hormone yi boa yɛn `Bone Marrow` ma ɛma mogya mu nkwammoaa kɔkɔɔ.

2. Renal Medulla : Eyi wɔ asaabo no mu fã. Nephrons dodow no ara wɔ ɔfã yi.

Enti, nnuruyɛfo frɛ tebea biara a ɛka asaabo no cortex anaa medulla no sɛ renal parenchyma yare. Wɔde din afoforo nso frɛ no, sɛ nhwɛso no, asaabo mu yare a ɛwɔ afã abien, ne asaabo mu yare.

Dɛn ne yare yi ahorow titiriw?

Yebetumi akyekyɛ yare yi mu ayɛ no ahorow atitiriw abien:

• Acute Renal Parenchymal Disease : Eyi fi ase mpofirim.
• Chronic Renal Parenchymal Disease : Eyi kɔ so nkakrankakra na ɛtra hɔ kyɛ.

So yare yi yɛ nea asiane wom?

Egyina nea ɛde tebea no ba ne sɛnea emu yɛ den so ankasa. Nsɛm bi a emu nyɛ den betumi ayɛ yiye bere a wɔsa yare no. Nanso wɔ nsɛm a emu yɛ den mu no, .Ebetumi akɔ so akodu `Asaabo a entumi nyɛ adwuma yiye.` Sɛnea wunim no, asaabo a entumi nyɛ adwuma yiye yɛ biribi a sɛ wɔansa a, ebetumi de nkwa ato asiane mu.

Dɛn ne nsɛnkyerɛnne a edi kan a wobetumi ahu?

Mpɛn pii no, sɛnkyerɛnne atitiriw biara nni yare yi mfiase. Ɛno na ɛma ɛyɛ hu kakra. Nanso bere a yare no kɔ so na w’asaabo ntumi nyɛ adwuma no, ebia wubehu sɛnkyerɛnne ahorow te sɛ eyinom:

• Mogya a ɛwɔ nsu mu (Hematuria) .
• Wora a ɛyɛ nwunu na ɛyɛ wo yaw
• Ɔbrɛ a ɛtra so a wɔte nka
• Akɔnnɔ
• Mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ mogya no mu a ɛso tew (Anemia) .
• Akisikuru ne ɔfe
• Nsu pii a wɔde fa mu sen sɛnea wɔtaa yɛ
• Aniwa no ho a ɛho ahonhon
• Nsa, nan, ne nansoaa a ɛho ahonhon (Edema) .

Sɛ wowɔ saa sɛnkyerɛnne yi mu biako anaa nea ɛboro saa a, ɛho hia yiye sɛ wobɛkɔ oduruyɛfo nkyɛn.

Dɛn na ɛde eyi ba?

Nneɛma atitiriw abien a ɛde asaabo mu yare a enni sabea ba ne mogya mmoroso ne asikreyare . Nanso, ebia nneɛma afoforo nso wɔ hɔ a ɛde ba:

• Nyarewa a nipadua no tumi ko tia nyarewa , te sɛ Lupus Nephritis
• Glomerulonephritis (asaabo no mu nneɛma a wɔde yiyi mu a ɛyɛ hyew) .
• `Asaabo mu Kokoram`
• Polycystic Kidney Disease ( asaabo mu akisikuru) .
• `Sickle Cell Yareɛ`

Nneɛma a ebetumi de asaabo mu yare a ɛba mpofirim (Acute) aba ne:

• Nneɛma a ɛma obi ho yɛ no hyew a emu yɛ den (Anaphylaxis) .
• `Mmoawa a Wɔde Nyarewa Ba`
• `Asaabo Abo`
• `Asaabo mu Akisikuru`
• Pulmonary Embolism (mogya a ɛtwetwe mogya ntini bi a ɛkɔ ahurututu mu) .
• `Nsuo a Ɛma Nsuo a Ɛyɛ Den`
• `Nyare mmoawa a wɔde nyarewa ba`

Nnuru bi nso betumi de saa `(Acute)` tebea yi aba. Nhwɛso ahorow:

• `Angiotensin-dannan enzyme inhibitors (ACE Inhibitors)`
• `Angiotensin II agyefo a wɔsiw ano (ARBs)`
• `Nnuru a ɛnyɛ steroid a ɛko tia ɔyare mmoawa (NSAIDs)` (e.g. Ibuprofen, Diclofenac) .

Hena na ɛda adi sɛ obenya saa yare yi?

Obiara betumi anya saa yare yi, nanso sɛ wowɔ nea edidi so yi a, asiane kɛse wom kakra:

• Sɛ obi wɔ abusua no mu a ɔwɔ saa asaabo mu yare yi a
• Sɛ wowɔ asikreyare a
• Sɛ wowɔ komayare a
• Sɛ wowɔ `High Blood Pressure` a

Afei nso, sɛ woadi boro mfe 60 na wode nnuru a wɔde kum ɛyaw a wɔmfa nnuru nhyɛ mu (OTC) ne nnuru a wɔkyerɛw ma wo di dwuma daa a, asiane a ɛwɔ hɔ no betumi ayɛ kɛse mpo.

Dɛn ne nsɛnnennen a ebetumi afi yare yi mu aba?

Sɛ wɔantumi anhyɛ saa yare yi so yiye a, nsɛnnennen ahorow betumi aba. Ebi ne:

• Nipadua mu nsu a ɛyɛ acid a ɛkɔ soro (Metabolic Acidosis) .
• Phosphate (phosphorus) dodow a ɛkɔ soro wɔ mogya mu (Hyperphosphatemia) .
• Potassium dodow a ɛkɔ soro wɔ mogya mu (Hyperkalemia) .
• Mogya mu nkwammoaa kɔkɔɔ dodow a ɛso tew (nemia) .
• Ɛyaw a ɛnam uric acid a ɛtɔ nkwaa mu (Gout) .
• Nnompe mu yare
• Nkwammoaa a ɛko tia nyarewa a ayɛ mmerɛw

Nea ɛho hia: Ɛnyɛ obiara na obehyia saa nsɛnnennen yi. Nanso, sɛ wohwɛ yare no so na wunya ayaresa a ɛfata a, wubetumi akwati wɔn kɛse.

Wobɛyɛ dɛn ahu yare yi pɛpɛɛpɛ? (Nyare a Wɔahu) .

Oduruyɛfo bi bebisa wo yare no ho sɛnkyerɛnne, ahwɛ w’ayaresa ho abakɔsɛm mu, abisa nnuru a wonom no ho asɛm, na wayɛ wo nipadua mu nhwehwɛmu. Afei, sɛ wosusuw sɛ wowɔ yare no a, wɔbɛhyɛ sɛ wɔnyɛ nhwehwɛmu mpɛn pii na ama wɔahu sɛ wowɔ yare no. Eyinom bi ne:

• Asaabo Dwumadi Ho Nhwehwɛmu : Eyinom bi ne mogya mu nhwehwɛmu ne nsu mu nhwehwɛmu . Mogya mu nhwehwɛmu hwɛ sɛnea wobu akontaa sɛ glomerular filtration rate (eGFR) ne serum creatinine dodow . Nsu mu nhwehwɛmu hwɛ sɛ proteinuria ne mogya wɔ nsu mu anaa.
• Mfonini mu nhwehwɛmu : Eyinom betumi aboa nnuruyɛfo ma wɔahu asaabo no kɛse, ne nsusuwii, ne sɛnea wɔahyehyɛ no yiye. Ebia wɔbɛkra sɛ wɔnyɛ ultrasound scan, MRI (Magnetic Resonance Imaging) scan, anaa CT (Computed Tomography) scan.
• Kidney Biopsy : Wɔ sɔhwɛ yi mu no, oduruyɛfo bi yi ntini ketewaa bi fi asaabo no mu na ɔsɔ hwɛ wɔ aduruyɛdan mu. Saa biopsy yi betumi ama wɔanya nsɛm a nhwehwɛmu afoforo ntumi nyɛ.

Ɔkwan bɛn so na wɔsa?

Sɛnea wɔsa adwene mu yare a ɛma obi nya adwene mu ntini mu yare no gyina nneɛma pii so. Eyinom bi ne:

• Nea ɛde yare no ba ankasa ne sɛnea emu yɛ den no.
• Wo mfe a woadi ne w’akwahosan nyinaa.

Ebia ayaresa a wubetumi apaw no bi ne:

• Kwati nnuru a wɔde kum ɛyaw a wɔfrɛ no NSAID ne nnuru afoforo a ebetumi ama asaabo mu yare asɛe kɛse bedi dwuma.
• Kwati tawanom koraa (sigaretnom, vaping, tawa a wɔwe, ne nea ɛkeka ho).
• Apɔw-mu-teɛteɛ a wɔde wɔn ho bɛhyɛ mu daa.
• Mu duru a ɛfata a wobɛkɔ so akura mu.
• Nnuru a ɛho hia a wɔbɛnom de asiw mogya mmoroso, srade, ne asikreyare ano.
• Wo ne Renal Dietitian nkasa na woanya aduan a mfaso wɔ so ma asaabo no. Ebia nea ɛka eyi ho ne aduan a ɛtew protein so, ɛtew mogya mu srade so, na ɛmma nkyene (sodium) ne potassium ano hye.

Sɛ yare no mu yɛ den a, ebia ayaresa a edidi so yi ho behia:

• Corticosteroids (aduru bi a ɛtew ɔfe so) .
• Dialysis (afiri mmoa a wɔde tew mogya no ho bere a asaabo no ntumi nyɛ adwuma yiye) .
• Nnuru a ɛma nipadua no tumi ko tia nyarewa (nnuru a ɛtew nipadua no mu tumi a ɛko tia nyarewa no dwumadi so) .
• `Asaabo a Wɔde Si ananmu`

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

Sɛ wowɔ saa yare yi a, ɛsɛ sɛ wo ne w’aduruyɛfo kuw no yɛ adwuma de hwɛ sɛnea w’asaabo asɛe no so na wokura ne dwumadi mu bere tenten biara a wubetumi. Nneɛma bi a ɛsɛ sɛ woyɛ ni:

• Aduan a mfaso wɔ so ma asaabo a wobɛkɔ so akura mu.
• Hwɛ asikre dodow a ɛwɔ wo mogya mu ne mogya mmoroso so daa.
• Kɔ asaabo ho ɔyaresafo nkyɛn na ma wɔnhwɛ w’asaabo daa.
• Aduru a oduruyɛfo no akyerɛw ama no a wɔbɛnom pɛpɛɛpɛ na wɔanom wɔ bere ano.

Bere tenten ahe na wubetumi ne yare yi atra ase?

Ɛyɛ den sɛ wobɛma asɛmmisa yi ho mmuae biako pɛ. Efisɛ egyina nneɛma pii so, te sɛ sɛnea yare no mu yɛ den, wo mfe a woadi, wo bɔbeasu, ne w’akwahosan nyinaa. Sɛ w’asaabo sɛe kɛse a, ebia wo nkwa nna so bɛtew. Sɛ woreyɛ dialysis a, mpɛn pii no wɔhwɛ kwan sɛ wobɛtra ase mfe 5 kosi 10.

Nanso kae! Eyi yɛ sɛ wɔkyekyem pɛpɛɛpɛ a, ɛyɛ nea wɔkyekyem pɛpɛɛpɛ. Nnipa pii tra ase kyɛ koraa bere a wɔsa wɔn yare yiye na wɔde asaabo foforo ma wɔn no. Nnipa a wɔwɔ adwene mu yare a ɛba awiei mpo betumi atra ase mfe 20-30. Enti, wo ne wo duruyɛfo nkasa na sua wo tebea no ho ade pii.

So akwan bi wɔ hɔ a yebetumi afa so akwati yare yi? (Ayaresa a wɔde siw ano) .

Ɛwom sɛ ɛnyɛ nea ɛde ba nyinaa na wobetumi asiw ano de, nanso wubetumi atew asiane a ɛwɔ hɔ sɛ wubenya yare no so denam nneɛma yi a wobɛyɛ so:

• Anyɛ yiye koraa no, fa wo ho hyɛ apɔw-mu-teɛteɛ a emu yɛ den mu nnanu dapɛn biara, anyɛ yiye koraa no simma 30 da biara.
• Nsã a wɔnom ano hye.
• Mu duru a ɛfata a wobɛkɔ so akura mu.
• Sɛ asiane kɛse wɔ hɔ sɛ wubenya asaabo mu yare (e.g. asikreyare, mogya mmoroso) a, kɔ oduruyɛfo nkyɛn daa kɔhwɛ wo.
• Kwati sigaretnom koraa.
• Nkyene dodow a wɔde ka nnuan ho a wɔbɛtew so.
• `NSAID`Fa nnuru a wɔde kum ɛyaw di dwuma sɛnea oduruyɛfo kyerɛ no nkutoo.

Nnuan bɛn na ɛsɛ sɛ obi a ɔwɔ saa yare yi kwati?

Sɛ wowɔ adwene mu yare a ɛma obi nya adwene mu ntini mu yare a, ɛho hia yiye sɛ wubehu adwene mu aduan ho ɔbenfo . Ɔbɛyɛ aduan ho nhyehyɛe a ɛfata wo na eye ma w’asaabo. Mpɛn pii no, ebehia sɛ woto nnuan a nkyene, protein, phosphorus, ne potassium pii wom ano hye. Nhwɛso ahorow bi ne:

• Avocado a wɔde yɛ nneɛma
• Kwadu
• Aduan a wɔde ahyɛ toa mu
• Nnuan a nkyene wom te sɛ chips ne pretzels
• Citrus nnuaba ne nsu, te sɛ akutu
• Nnuaba a ayow
• Nam a wɔayɛ ho adwuma (te sɛ soseji, nam a wɔayam) .
• Spinach

Nea ɛho hia: Ebia saa nsɛm a wɔahyehyɛ yi nyɛ obiara dea. Bisa wo aduan ho ɔbenfo ma ɔmma no afotu pɔtee wɔ nnuan a eye ma wo ne nea ɛsɛ sɛ wokwati ho.

Bere bɛn na ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn?

Sɛ wowɔ asikreyare, mogya mmoroso, anaa tebea foforo a ebetumi ama woanya asaabo mu yare a, kɔ wo duruyɛfo nkyɛn daa ma wɔnhwɛ wo. Sɛ wuhu nneɛma a ɛde asiane ba wo ho ntɛm na wote ase a, ebetumi aboa ma woasiw w’asaabo a ɛsɛe bio no ano.

Bere bɛn na ɛsɛ sɛ wokɔ Emergency Treatment Unit (ETU) ?

Mpɛn pii no, adwene mu yare a ɛma obi nya adwene mu ntini mu yare ho sɛnkyerɛnne da adi bere a asaabo no asɛe kɛse akyi. Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, kɔ oduruyɛfo nkyɛn ntɛm ara:

• Sɛ ntini no taa twitwiw a
• Sɛ wowɔ aduan ho akɔnnɔ a
• Sɛ wote nka sɛ woabrɛ paa a
• Sɛ ɛyɛ den ma wo sɛ wode w’adwene besi biribi so anaasɛ wobɛda a
• Sɛ wowɔ honam ani a ɛyɛ wo yaw a
• Sɛ wowɔ hiccups a ɛrennyae
• Sɛ wo nsa, wo nansoaa, anaa wo nan ho ahonhon a
• Sɛ woretow wo ho boro so anaasɛ woretow nsu asen sɛnea ɛte daa a

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Sɛ wokɔ oduruyɛfo nkyɛn a, ebia ɛbɛyɛ nea mfaso wɔ so sɛ wubebisa nsɛm yi:

• Wobɛyɛ dɛn ahu sɛ mewɔ renal parenchymal yare?
• Ɛyɛ aniberesɛm dɛn?
• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• Dɛn na metumi ayɛ de abɔ m’asaabo ho ban?
• So wubetumi akamfo aduan ho ɔbenfo titiriw bi akyerɛ wɔn a wɔwɔ asaabo mu?
• So wubetumi aka kuw bi a wɔboa a wɔboa nnipa a wɔwɔ yare yi ho asɛm akyerɛ me?

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

Renal Parenchymal Disease yɛ tebea a ɛka w’asaabo dwumadi. Botae titiriw a ɛwɔ ayaresa mu ne sɛ wobedi yare no ho dwuma na ama asaabo no akɔ so ayɛ adwuma bere tenten biara a wobetumi. Nnipa pii de saa yare yi tra ase mfe pii.

Nanso, sɛ wohu sɛ yare no te sɛ eyi na ɛsɛ sɛ woyɛ ayaresa bere nyinaa a, ebia wobɛte abasamtu ne abufuw nka. Eyi yɛ ade a ɛfata. Sɛ wo ne w’abusuafo ne wo nnamfo a wogye wɔn di bɛka eyi ho asɛm a, ebetumi aboa wo. Wubetumi nso akɔka akuw a wɔboa nnipa a wɔwɔ saa tebea yi ho. Sɛ wowɔ nsɛmmisa bi a, nsuro sɛ wo ne wo duruyɛfo bɛkasa. Wɔbɛboa wo. Ɛnyɛ wo nko ara!

` Asaabo mu yare, asaabo mu yare, asaabo mu ntini, asaabo dwumadi, asaabo a entumi nyɛ adwuma yiye, asaabo mu yare, asaabo dwumadi, asikreyare, mogya mmoroso