Ðe esia nye afɔku na wò ayikuwo hã? (Renal Papillary Necrosis) Mina míasrɔ̃ nu tso eŋu!

Ènya dɔ si gbegbe ayiku sue eve siwo le míaƒe ŋutilã me wɔnaa? Le nyateƒe me la, ayikuwoe nye ŋutinu vevi siwo ɖea gbeɖuɖɔwo ɖa hekɔa ʋu si le míaƒe ŋutilã me ŋu. Ke hã, ɣeaɖewoɣi la, ayiku siawo hã ate ŋu axɔ dɔléle siwo míele mɔ kpɔm na o. Egbea míele nu ƒom tso nɔnɔme aɖe si nu sẽ vie ŋu, gake ne ènyae la, ate ŋu akpe ɖe ŋuwò nàɖu edzi ahaxe mɔ ɖe enu.

Aleke ayikuwo wɔa dɔe? Nukae nye Ayiku ƒe Ʋuʋudedi?

Kpuie ko la, míaƒe ayikuwo le abe super filter eve siwo le míaƒe ŋutilã me ene. Woƒe dɔ vevitɔe nye be woaɖe gbeɖuɖɔ siwo womedi o siwo le ʋua me la ɖa eye woaɖe wo ɖa abe aɖuɖɔ ene. Be woate ŋu awɔ esia la, ʋu gena ɖe ayikuwo me eye wòtoa mɔ sue geɖewo me. Woƒoa gbeɖuɖɔ siawo nu ƒu tso ayiku ƒe gota gome eye emegbe wova ɖoa ayikua titina, si nye ayiku ƒe lãkusi . Akpa siwo le abe funnel ene ye nye esi. Funnel siawo ƒe nugbɔ, si woyɔna be renal papilla, ƒoa aɖuɖɔ nu ƒu. Tso afima la, aɖuɖɔa toa tsinyegoeawo me yia tsinyegoea me eye wòdoa go. Aleae míaƒe ayikuwo wɔa dɔe.

Ayiku ƒe ʋuʋudedi si ŋu míele nu ƒom tsoe fifia enye lãmenugbagbeviwo kple lãkusi siwo le ayiku ƒe titina ƒe akpa (`Medulla`) kple ayiku ƒe lãkusi (`Ayiku ƒe Papilla`) si megblɔ va yi ƒe ku. Bu eŋu kpɔ ko, ne teƒe mawo mewɔa dɔ nyuie o la, dɔ si ayikuwo wɔna la mewɔa dɔ nyuie o, alo? Le esia ta la, ayikuawo gbɔdzɔna vivivi, eye ate ŋu ana ayikuawo nawɔ dɔ nyuie mlɔeba .

Amekae le afɔku me wu le nɔnɔme sia me?

Dɔléle sia (Renal Papillary Necrosis) bɔ ɖe amesiwo xɔ wu ƒe 60. Ðɔktawo hã ɖee fia be nyɔnuwo ate ŋu axɔe wu ŋutsuwo.

Nukawoe hea Ayiku ƒe Ʋuʋudedi vɛ?

Nu vevi geɖewo li siwo gbɔ dɔléle sia tsona. Na míalé ŋku ɖe nusiwo wonye ŋu.

• Suklidɔ : Esiae nye nu ɖeka kolia si le vevie wu eye wòbɔ wu. Amesiwo ŋu suklidɔ si dzi womekpɔa ŋusẽ ɖo nyuie o le afɔku gã aɖe me be ayiku nagblẽ. Sukli ƒe agbɔsɔsɔ si sɔ gbɔ ɖe ʋu me le ɣeyiɣi didi aɖe me gblẽa ʋuka tsɛ siwo le ayikuawo me.
• Vevesesenutsitikewo zazã fũ akpa (NSAIDs) : Ne èzãa vevesesenutsitikewo (atike siwo me steroid mele o siwo tsia dzodzodzoetsitsi nu, alo NSAIDs) abe aspirin, ibuprofen, alo naproxen ene ɣesiaɣi evɔ mèbia ɖɔkta o la, ele be nàɖɔ ŋu ɖo ŋutɔ. Esiawo nono fũ ate ŋu ana ʋuka siwo le ayiku me natsi eye woagblẽ ayiku ƒe lãkusiwo.
• Sickle Cell Dɔléle: Esia nye domenyiŋusẽfianu ƒe dɔléle. Le dɔléle sia me la, ʋumenugbagbevi dzĩwo ƒe nɔnɔme trɔna eye woate ŋu atsi ʋukawo me. Esia ate ŋu ana ʋu nayi ayikuawo hã nagbɔdzɔ (Renal Papillary Necrosis).

Tsɔ kpe ɖe nu vevi siawo siwo gbɔ wòtsona ŋu la, nɔnɔme bubu geɖewo hã ate ŋu ahe Renal Papillary Necrosis vɛ:

• Aklãdɔléle si Nɔa Anyi Didi
• Pyelonephritis, si nye dɔlékui aɖe si xɔa ayikuwo (si ate ŋu agblẽ nu le ayiku ƒe lãkusiwo ŋu) .
• Ayiku me Yɔmekpe, si nye dɔléle si gblẽa nu le ayiku siwo le lãkusi godo ŋu
• Renal Vein Thrombosis (ʋu ƒe sisi le ʋuka si tsɔa ʋu tso ayiku me) .
• Ureteral Obstruction (le kpɔɖeŋu me, le tsinyegoe me kpewo ta) .
• Vasculitis, si nye ʋukawo ƒe dɔdzẽ

Nu vevitɔe nye be menye amesiame si ŋu nu siawo dometɔ ɖeka alo esi wu nenema le lae axɔ (Renal Papillary Necrosis). Gake afɔkua lolo wu.

Ðe esia gblẽa nu le ayiku eveawo siaa ŋua?

Ẽ, woka nya ta be le ame siwo ade adre le ewo ɖesiaɖe me gome la , dɔléle sia (Renal Papillary Necrosis) gblẽa nu le ayiku eveawo siaa ŋu .

Nukae nye (Renal Papillary Necrosis) ƒe dzesiwo?

Le dɔléle sia ƒe gɔmedzedze la, ɖewohĩ dzesi aɖeke manɔ eŋu o . Esia tae esesẽna be woade dzesii ahadae kaba ɖo. Bu eŋu kpɔ, kuxi aɖeke mele ŋuwò o, gake wò ayiku ate ŋu agblẽ tso ememe. Gake ate ŋu adzɔ hã be woakpɔ esia le vo me ne wole dɔléle bubu dom kpɔ.

Gake ne nɔnɔmea (Renal Papillary Necrosis) nu sẽ ɖe edzi la, dzesiwo abe esiawo ene ate ŋu adze:

• Aɖuɖɔtoe si me vevesese le (Dysuria) .
• Asrã kple vuvɔ (vevietɔ ne dɔlékui aɖe kpe ɖe eŋu) .
• Ʋu si le aɖuɖɔ me (`Hematuria`) - Ʋu ƒe agbɔsɔsɔme ateŋu akpɔe kple ŋku dzro (aɖuɖɔa ateŋu azu dzĩ alo aŋutiɖiɖi), alo ateŋu anɔ sue ale gbegbe be woateŋu akpɔe le nusuekpɔmɔ̃ me ko.
• Hiahiã be woaɖe aɖuɖɔ enuenu le zã me (`Nocturia`) .
• Ʋumenugbagbevi ɣi siwo le aɖuɖɔ me ƒe dzidziɖedzi si mesɔ o (`Pyuria`) - esia fia be aɖuɖɔa ate ŋu adze abe ʋuʋudedi ene, eye aɖuɖɔa ate ŋu adze abe alilikpo ene.
• Vevesese sesẽ le akɔta ƒe akpa eveawo, akɔta kple akɔtaƒuwo dome (afisi ayikuwo le). Vevesese sia ate ŋu ava kpata alo adzi ɖe edzi vivivi.
• Aɖuɖɔtoe me dɔlélewo xɔxɔ enuenu.

Aleke wowɔna kpɔa Ayiku ƒe Dɔléle si woyɔna be Renal Papillary Necrosis?

Ðɔktawo awɔ dodokpɔ geɖe atsɔ anya dɔléle sia (Renal Papillary Necrosis). Ne woɖo to wò dzesiwo kple atikewɔwɔ ŋutinya vɔ la, woate ŋu abia be woawɔ dodokpɔwo abe:

• Urography ƒe nɔnɔmetata: Esia bia be nàwɔ wò ayiku ƒe X-ray, CT scan, alo MRI. Hafi woadoe kpɔ la, woana amadede tɔxɛ aɖe (amadede) wò to ʋuka aɖe me. Esia kpena ɖe ame ŋu wòkpɔa teƒe siwo ayikuawo gblẽ kple tɔtrɔ siwo va le papillae me la nyuie.
• Ureteroscopy : Esia bia be woatsɔ mɔ̃ tsɛ aɖe si te ŋu trɔna bɔbɔe (si ƒe nugbɔ le fotoɖemɔ̃) me to tsinyegoea me be woakpɔ tsinyegoe, tsinyegoewo, kple ayikuwo me tẽ. Esia wɔnɛ be wokpɔa alesi papillae la le nyuie.
• Ayiku me Dzodzro : Le dodokpɔ sia me la, wotsɔa aŋe tɔxɛ aɖe ɖea lãkusi sue aɖe tso ayiku me eye wodoa eŋu le nusuekpɔmɔ̃ me. Esia ate ŋu akpe ɖe ame ŋu wòanya ne lãmenugbagbeviwo ku alo lãmenugbagbeviawo gblẽ.

Ʋu kple aɖuɖɔ dodokpɔ

Tsɔ kpe ɖe eŋu la, ʋu kple aɖuɖɔ dodokpɔ be woatsɔ akpɔ ayiku ƒe dɔwɔwɔ hã le vevie ŋutɔ:

• Ʋu me urea nitrogen (BUN) dodokpɔ : Esia dzidzea urea nitrogen agbɔsɔsɔme si le ʋua me. Esia nye gbeɖuɖɔ. Agbɔsɔsɔ sia dzina ɖe edzi le ʋua me ne ayikuawo mele dɔ wɔm nyuie o.
• Creatinine dodokpɔ : Creatinine nye gbeɖuɖɔ bubu si wowɔna le lãmekawo ƒe dɔwɔwɔ nyuie me. Zi geɖe la, ayikuwoe ɖenɛ doa goe. Ne eƒe agbɔsɔsɔ sɔ gbɔ ɖe ʋua me la, efia hã be ayikuawo mele dɔ wɔm nyuie o.
• Glomerular Filtration Rate (eGFR) si Wobu : Wobua esia to nusiwo nye creatinine ƒe agbɔsɔsɔ le ʋu me, ƒe si nèxɔ, ŋutsu alo nyɔnu nyenye, kple ŋutilã ƒe lolome ŋu bubu me. eGFR ƒe asixɔxɔa gblɔa ʋu agbɔsɔsɔme si wò ayikuwo ɖena le aɖabaƒoƒo ɖeka me la na wò. Zi alesi asixɔxɔ sia le ʋɛe la, zi nenemae wò ayikuwo mewɔa dɔ nyuie o.
• Aɖuɖɔtoe me dzodzro : Esia bia be woatsɔ aɖuɖɔtoe aɖe akpɔe ahalé ŋku ɖe eŋu kple ŋku (amadede, eme kɔ), nusuekpɔmɔ̃ (na ʋumenugbagbeviwo, ʋuʋudedi lãmenugbagbeviwo, dɔlékuiwo, aɖuɖɔtoe ƒe gbeɖuɖɔwo), kple atikewo (na protein, sukli). Ɣeaɖewoɣi la, woate ŋu akpɔ ayiku ƒe lãkusi kakɛwo hã le nusuekpɔmɔ̃ me.
• Aɖuɖɔ me protein/creatinine ƒe xexlẽme : Esia dzidzea protein agbɔsɔsɔme si le aɖuɖɔ me. Ayiku siwo le lãmesẽ me ɖea protein ʋɛ aɖewo ko doa goe. Protein ƒe agbɔsɔsɔ fũ le aɖuɖɔ me nye ayiku ƒe gbegblẽ ƒe dzesi.

Nukawoe nye kuxi siwo ate ŋu ado tso (Renal Papillary Necrosis) me?

Ne womeda dɔléle sia (Renal Papillary Necrosis) nyuie o la, nɔnɔmea ate ŋu agblẽ ɖe edzi eye wòahe kuxi sesẽwo vɛ.

• Ayikudɔléle si nɔa anyi didi (CKD) : Le ayikuawo ƒe gbegblẽ atraɖii ta la, woƒe dɔwɔwɔ dzi ɖena kpɔtɔna vivivi, si wɔnɛ be ayikudɔléle si nɔa anyi didi.
• Ayikuwo ƒe Dɔmawɔmawɔ nyuie: Ne nɔnɔmea gagblẽ ɖe edzi la, ayikuawo ate ŋu awɔ dɔ nyuie kura, si fia be woate ŋu ava zu ayiku ƒe dɔmawɔmawɔ nyuie.
• Be nàtsi agbe la, ɖewohĩ ahiã be woado ayiku na wò (wòatsɔ mɔ̃ akɔ wò ʋu ŋu) alo woado ayiku na wò .
• Wokpɔe hã be nɔnɔme sia nana be kansa ƒomevi aɖe si woyɔna be transitional cell cancer, si dzɔna le ayiku alo tsinyegoe me la xɔxɔ ƒe afɔkua dzina ɖe edzi.
• Afɔku hã li be woaxɔ dɔlékui sesẽwo (sepsis).

Aleke wodaa ayiku ƒe dɔléle si woyɔna be Renal Papillary Necrosis?

Atike aɖeke koŋ meli na Ayiku ƒe Ʋuʋudedi ƒe Dɔléle o. Atikewɔwɔ vevitɔe nye be woada nusi gbɔ dɔlélea tso . Le kpɔɖeŋu me:

• Ne suklidɔ gbɔe wòtso la, ekema ele vevie be woaɖu suklidɔa dzi nyuie.
• Ne NSAID zazã gbɔe wòtso la, dzudzɔ atike mawo nono.
• Ne dɔlékui aɖe gbɔe wòtso la, na dɔlékuiwutikewoe.
• Ne aɖuɖɔtoea xe la, ele be woaɖee ɖa.

Taɖodzinu vevitɔe nye be woaɖe ayikuawo ƒe nugbegblẽ bubuwo dzi akpɔtɔ eye woakpɔ ayikuwo ƒe dɔwɔwɔ ta alesi woate ŋui.

Atikewɔwɔ ƒe dzidzedzekpɔkpɔ nɔ te ɖe alesi gbegbe ayiku gblẽe kple nusi gbɔ dɔlélea tso dzi. Le dɔléle sesẽ aɖewo me la, dɔlélea ate ŋu ayi edzi anɔ sesẽm ɖe edzi togbɔ be wodae hã. Gake le nɔnɔme siwo mesẽ boo o me, eye ne woda nusi gbɔ wòtso kaba la, ayiku ƒe dɔwɔwɔ ate ŋu ali ke alo anyo ɖe edzi vie gɔ̃ hã.

Ðe mate ŋu akpɔ ɖokuinye ta tso Renal Papillary Necrosis si mea?

Ẽ, nanewo li míate ŋu awɔ atsɔ akpɔ mía ɖokui ta tso nɔnɔme sia me, le agbɔsɔsɔ gã aɖe me.

• Nu vevitɔ kekeakee nye be nàlé wò lãmesẽ bliboa me ɖe asi . Nuɖuɖu si da sɔ ɖuɖu, tsi si sɔ nono, kple kamedede edziedzi le vevie.
• Ne èle vevesesenutsitike siwo womeƒlena le atikedzraƒe o (NSAID) zãm la, zã wo abe alesi woŋlɔe ɖe agbaa dzi alo abe alesi ɖɔkta gblɔe ene ko. Mègano wo zi geɖe alo ɣeyiɣi didi wu alesi wòhiã o. Mègano wo edziedzi le vevesese kple vevesese suesuesuewo alo taɖuame ta o.
• Ne suklidɔ (Diabetes Mellitus), sickle cell disease (Sickle Cell Disease), alo dɔléle bubu siwo ate ŋu ahe ayikudɔ (Renal Papillary Necrosis) le ŋuwò la, wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi pɛpɛpɛ. Yi atikewɔƒewo ɖe game dzi. No atike siwo woŋlɔ na wò. Wɔ ɖe nuɖuɖu si sɔ dzi.
• Ele vevie ŋutɔ be nàwɔ dodokpɔ le dodokpɔxɔ me be nàlé ŋku ɖe ayiku ƒe dɔwɔwɔ ŋu edziedzi abe alesi wò ɖɔkta gblɔe ene, eye nàde dzesi tɔtrɔ ɖesiaɖe kaba.

Nukae nye amesi ŋu dɔléle sia le ƒe hayahaya ƒe agbɔsɔsɔme?

Wò ŋgɔdonya nɔ te ɖe nusi gbɔ dɔlélea tso, alesi gbegbe ayiku gblẽe, wò lãmesẽ bliboa, kple alesi nèdze atikewɔwɔ gɔme kabae dzi.

• Le suklidɔlélawo gome la, emetsonuwo ate ŋu manyo vie o , elabena suklidɔ nye dɔléle si nɔa anyi didi eye womekpɔa edzi nyuie ɣesiaɣi o. Ne suklidɔ le ŋuwò la, edzi ɖuɖu nyuie alesi nàte ŋui awɔ akpa gã aɖe le mɔxexe ɖe ayiku ƒe gbegblẽ nu me.
• Le dɔléle sesẽwo me (Renal Papillary Necrosis) la, ate ŋu ana woaɖe ayiku me eye woado ayiku na ame . Ne dɔlékuiwo dze ame dzi la, ate ŋu ade ame ƒe agbe afɔku me. Ate ŋu adzɔ be ame naku le ayiku ƒe dɔmawɔmawɔ nyuie ta.
• Le sickle cell dɔléle me la, ayiku ƒe ʋuʋu nye kuxi geɖe siwo ate ŋu ado mo ɖa le ayiku me la dometɔ ɖeka ko. Ne wotsɔ kuxi siawo katã ƒo ƒui la, woate ŋu aɖe dɔnɔa ƒe agbenɔƒe dzi akpɔtɔ ŋutɔ.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò la, mègagblẽ ɣeyiɣi o eye nàyi ɖɔkta gbɔ godoo :

• Ne ʋu le wò aɖuɖɔ me (aɖuɖɔ trɔna zua dzĩ, pink, alo blɔ).
• Ne asrã alo vuvɔ le ŋuwò (vevietɔ ne dzesi bubuwo le ŋuwò).
• Ne vevesese alo dzobibi le ŋuwò ne èle aɖuɖɔ tom.
• Ne vevesese yeye alo esi le sesẽm ɖe edzi le wò akɔta ƒe akpa eveawo la, le teƒe si le wò akɔtaƒuwo kple akɔtaƒuwo dome (ayiku ƒe akpa).
• Ne èxɔa aɖuɖɔtoedɔléle enuenu.
• Ne èkpɔ be aɖuɖɔtoe dzi ɖe kpɔtɔ alo wò afɔwo kple afɔkpodziwo vuvu (esiawo ate ŋu anye ayiku ƒe dɔwɔwɔ dzi ɖeɖe kpɔtɔ ƒe dzesiwo).

Ðo ŋku edzi be dɔléle bubuwo hã ate ŋu ahe dzesi siawo vɛ. Gake ele vevie be ɖɔkta nado wò kpɔ be yeanya nusi tututu gbɔ wòtso.

Mlɔeba la, nusi dzi nàɖo ŋkui (Take-Home Message) .

Míaƒe ayikuwo nye ŋutinu vevi aɖe na míaƒe ŋutilã, eye wòwɔa dɔ vevi aɖe si me ɖoɖoezizi le. Woɖea gbeɖuɖɔwo ɖa eye tsi kple dze nɔa ŋutilãa me. Suklidɔ si dzi womate ŋu aɖu o, vevesesenutsitikewo (NSAIDs) zazã fũ akpa, kple atikewɔwɔ me nɔnɔme vovovo bubuwo ate ŋu agblẽ nu le ayikuwo ŋu, si ahe nɔnɔme sesẽwo abe Renal Papillary Necrosis ene vɛ.

Nusi gblẽ le dɔléle sia ŋu wue nye be ɖewohĩ dzesi aɖeke manɔ ŋuwò le eƒe gɔmedzedze o. Eyata ne suklidɔ le ŋuwò, èzãa NSAID enuenu, alo nu bubu siwo ate ŋu ana ayikudɔ nadze ŋuwò la, ƒo nu kple wò ɖɔkta tso mɔ siwo dzi nàto akpɔ wò ayiku ta ŋu. Ne èdo wò ayiku kpɔ edziedzi eye nèzɔ ɖe agbe nyui nɔnɔ dzi la, àte ŋu ana wò ayiku nanɔ lãmesẽ me. Nyanyanya kaba kple nuwɔwɔ nye nu nyuitɔ kekeake ɣesiaɣi.

` Ayiku, ayiku ƒe ʋuʋu, ayiku ƒe dɔléle, suklidɔ, NSAID, ayiku ƒe dɔmawɔmawɔ nyuie, aɖuɖɔ