Ua manaʻo paha ʻoe ua like ko kākou mau puʻupaʻa me ʻelua mau kānana nui? ʻAe, ʻo ia ka mea e hana ʻia. ʻO ka hana nui o nā puʻupaʻa, ʻo ia ke kānana ʻana i nā huahana ʻōpala i makemake ʻole ʻia, nā mea ʻawahia, a me ka wai keu i loko o ko kākou koko. Akā i kekahi manawa ua hōʻino ʻia kēia kānana a ua pau ka hana pono ʻana. ʻO kēia emi mālie ʻana o ka hana o nā puʻupaʻa i ka hala ʻana o ka manawa, ʻo ia ka mea a mākou e kapa nei he Chronic Kidney Disease (CKD) .
I ka ʻōlelo maʻalahi, he aha ka maʻi puʻupaʻa mau loa (CKD)?
E noʻonoʻo e paʻa mālie ana kāu kānana wai home. I ka wā mua, ʻaʻole ʻoe e ʻike i ka ʻokoʻa nui, akā i ka hala ʻana o ka manawa, lohi ke kahe ʻana o ka wai a loli ka ʻono o ka wai. ʻO ia ka mea e hana ʻia ke hōʻino ʻia kou mau puʻupaʻa.
Ke hōʻino ʻia nā puʻupaʻa, ʻaʻole hiki iā lākou ke kānana pono a wehe i nā ʻōpala mai ke koko. A laila hoʻomaka kēia mau ʻōpala e hōʻiliʻili i loko o ke koko. Hoʻohana ʻia ka huaʻōlelo "chronic" no ka mea e ulu ana kēia ʻano ma hope o ka manawa. ʻAʻole kēia he maʻi e ulu koke ana.
ʻO ka mea nui, ʻaʻole e loaʻa i nā kānaka a pau me kēia maʻi ka hāʻule ʻana o nā puʻupaʻa. Me ka mālama kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki iā mākou ke kāohi i ka hōʻino ʻia o nā puʻupaʻa a mālama i kā lākou hana no ka lōʻihi e hiki ai.
He aha ka mea e hana maoli ana i ko kākou mau puʻupaʻa?
Loaʻa iā kākou ʻelua mau puʻupaʻa. Aia kēia mau ʻōkana ʻano pīni ma ko kākou kua, ma nā ʻaoʻao ʻelua o ko kākou iwi kuamoʻo, ma lalo pono o ko kākou iwi ʻaoʻao. ʻO ka nui o hoʻokahi puʻupaʻa e like me ka nui o ka poho lima. ʻOiai ʻo kā lākou hana nui ke kānana i ke koko, hana pū lākou i nā hana koʻikoʻi ʻē aʻe he nui.
- Hoʻomaʻemaʻe koko: Hoʻokuʻu ʻia nā huahana ʻōpala, nā mea ʻawahia, a me ka wai keu i loko o ke koko ma ke ʻano he mimi.
- Ke kaulike ʻana i nā paʻakai a me nā minelala: Kōkua i ka mālama ʻana i ka nui kūpono o nā electrolytes (paʻakai) e pono ai ke kino, e like me ka sodium a me ka potassium.
- Ka hana ʻana o ka hormone: Hoʻopuka ʻia nā hormones e kaohi ana i ke koko a me nā hormones e hana ana i nā hunaola koko ʻulaʻula e nā puʻupaʻa.
- Mālama i nā iwi i ikaika: Hoʻoulu ka Vitamin D a kōkua i ka mālama ʻana i nā iwi i ikaika.
Inā ʻaʻole hana pono ʻia kēia mau mea, e hōʻiliʻili nā ʻōpala i loko o ke kino a maʻi mākou.
He aha nā pae 5 o ka maʻi puʻupaʻa?
E nā kauka, aia kekahi ana o ka maikaʻi o ka hana ʻana o kou mau puʻupaʻa. Ua kapa ʻia ʻo GFR (Glomerular Filtration Rate) . I ka ʻōlelo maʻalahi, ana kēia i ka nui o nā milliliters o ke koko e kānana ʻia e kou mau puʻupaʻa i kēlā me kēia minuke. Hoʻohana ʻia kēia waiwai GFR e hoʻokaʻawale i ka maʻi i ʻelima mau pae. Hiki ke loaʻa kēia waiwai ma o nā hoʻāʻo koko a me ka mimi.
| Kahua | Ka waiwai GFR (mL/min) | Manaʻo |
|---|---|---|
| Pae 1 | 90 a ʻoi aku paha | Aia kahi pōʻino iki i nā puʻupaʻa, akā ua maʻamau kā lākou hana. |
| Pae 2 | 60 - 89 | Ua emi iki ka hana o nā puʻupaʻa. |
| Pae 3 | 30 - 59 | Ua emi iki ka hana o nā puʻupaʻa. |
| Pae 4 | 15 - 29 | Ua emi nui ka hana o nā puʻupaʻa. |
| Pae 5 | Ma lalo o 15 | Ua kokoke e hāʻule loa nā puʻupaʻa (Kidney Failure). |
He aha nā hōʻailona o kēia maʻi?
ʻO ka pilikia nui me kēia maʻi, ʻaʻole ia e hōʻike i nā hōʻailona i nā pae mua . Hiki ke hala nā makahiki no ka hōʻiliʻili ʻana o ka ʻōpala i loko o ke kino a hōʻike i nā hōʻailona. ʻO ia ke kumu i ʻike ʻole ai ka poʻe he nui ua loaʻa iā lākou kēia maʻi. I ka holomua ʻana o ka maʻi, hiki iā ʻoe ke ʻike i nā mea e like me:
- Pono e mimi pinepine.
- Manaʻo luhi loa a me ke ola ʻole.
- ʻAʻohe ʻono o ka meaʻai.
- Ka pehu ʻana o nā lima, nā wāwae, a me nā kuʻekuʻe wāwae.
- Paʻakikī ka hanu ʻana.
- Mimi huʻa (pehu).
- Ka pehu ʻana ma lalo o nā maka.
- ʻIli maloʻo a ʻānai.
- Ka paʻakikī i ka noʻonoʻo ʻana i kekahi mea.
- ʻAʻole hiki ke hiamoe.
- Ke ʻano ʻūlū ma kekahi mau wahi o ke kino.
- Ka luaʻi a i ʻole ka luaʻi ʻana.
- ʻŌpū ʻiʻo.
- Hoʻonui ʻia ke koko.
- Ka ʻeleʻele ʻana o ka ʻili.
Hiki ke ʻike ʻia kēia mau hōʻailona i nā maʻi ʻē aʻe, no laila inā loaʻa iā ʻoe kekahi mea e like me kēia, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke ʻike i kāu kauka no ka ʻōlelo aʻo.
He aha nā kumu nui o ka maʻi puʻupaʻa?
Loaʻa kēia maʻi i ka wā e hōʻino ʻia ai nā puʻupaʻa a ʻaʻole hana pono hou. I ka maʻi puʻupaʻa mau loa, hana mālie kēia hōʻino, i nā makahiki he nui. ʻElua mau kumu nui no ka ulu ʻana o kēia maʻi ma Sri Lanka a puni ka honua.
1. Ke koko kiʻekiʻe: Ke piʻi aʻe ke koko, ua hōʻino ʻia nā kīʻaha koko palupalu e hoʻolako ana i ke koko i nā puʻupaʻa. I ka hala ʻana o ka manawa, hōʻemi kēia hōʻino i ka hiki o nā puʻupaʻa ke kānana i ke koko.
2. Maʻi diabetes: Ke piʻi aʻe ke kō koko, hōʻino pū ia i nā ʻāpana kānana maikaʻi (glomeruli) i loko o nā puʻupaʻa.
Ma waho aʻe o kēia mau kumu nui ʻelua, aia paha he nui nā kumu ʻē aʻe.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Nā kumu nui | Ke koko kiʻekiʻe (hypertension) a me ka maʻi diabetes. |
| ʻO ka Glomerulonephritis | Ka hōʻino ʻana i nā ʻāpana kānana (glomeruli) i loko o nā puʻupaʻa. |
| Maʻi puʻupaʻa polycystic | He maʻi hoʻoilina kēia e hoʻoulu ai i nā cysts piha i ka wai he nui i loko o nā puʻupaʻa. |
| Ka ālai ʻana o ke ala mimi | Ka ālai ʻia ʻana o ka mimi ma muli o nā pōhaku puʻupaʻa, ka prostate i hoʻonui ʻia, a i ʻole ke kanesa. |
| Nā maʻi puʻupaʻa e hana hou ʻia (Pyelonephritis) | Nā maʻi bacteria pinepine o nā puʻupaʻa. |
| Nā maʻi ʻē aʻe | Nā maʻi o ka ʻōnaehana pale e like me lupus. |
ʻO wai ka mea i pilikia nui?
Hiki i kekahi ke loaʻa i ka maʻi puʻupaʻa mau loa. Eia nō naʻe, ʻoi aku kou pilikia inā loaʻa iā ʻoe kekahi o kēia mau mea:
- Inā he maʻi diabetes kou.
- Inā he koko kiʻekiʻe kou.
- Inā he maʻi puʻuwai kou.
- Inā ua loaʻa kekahi o ka ʻohana i ka maʻi puʻupaʻa.
- Inā ʻoe ma luna o 60 mau makahiki.
- Inā ʻoe e lawe nei i nā lāʻau ʻeha (NSAID) , ʻo ia hoʻi, kekahi mau ʻano lāʻau ʻeha hiki iā ʻoe ke kūʻai ma ka hale kūʻai lāʻau lapaʻau, no ka manawa lōʻihi.
Pehea e ʻike ai i ka maʻi?
Ke hele ʻoe e ʻike i ke kauka, e nīnau ʻo ia e pili ana i kou mōʻaukala olakino, ka mōʻaukala ʻohana, nā lāʻau lapaʻau āu e lawe ai, a me nā hōʻailona āu e ʻike nei. A laila, e hana lākou i kahi hoʻokolohua kino a kauoha i kekahi mau hoʻokolohua koko a me ka mimi e nānā i ka hana o kāu puʻupaʻa.
- Nā hoʻāʻo koko: Nānā nui kēia i kāu GFR a me nā pae creatinine serum . He huahana ʻōpala ka Creatinine i hana ʻia e ko mākou mau ʻiʻo. Hoʻokuʻu nā puʻupaʻa olakino iā ia i loko o ka mimi. Ke hāʻule nā puʻupaʻa, hōʻiliʻili ka creatinine i loko o ke koko.
- Nā hoʻāʻo mimi: Nānā kēia i ka protein (albumin) a i ʻole ke koko i loko o ka mimi. ʻAʻole ʻae nā puʻupaʻa olakino i kēia mau mea e komo i loko o ka mimi.
I kekahi manawa, hiki ke hana ʻia kekahi mea e like me ke kiʻi ultrasound e nānā i ka nui a me ke ʻano o nā puʻupaʻa. A i ʻole, hiki ke hana ʻia kahi biopsy puʻupaʻa , ʻo ia hoʻi ka lawe ʻana i kahi ʻāpana liʻiliʻi loa o ka puʻupaʻa a nānā iā ia.
Pehea e mālama ʻia ai?
ʻAʻole hiki ke ho'ōla piha ʻia ka maʻi puʻupaʻa mau loa. Akā hiki iā mākou ke hōʻemi i ka pōʻino o nā puʻupaʻa a mālama iā lākou e hana ma kahi pae maikaʻi no ka lōʻihi e hiki ai. Eia kekahi mau mea e hana ai.
E hoʻomanaʻo, pono e hana ʻia kēia mau mea a pau e like me nā kuhikuhi a kāu kauka.
Nā loli o ke ʻano o ka nohona
- Ke kipa pinepine ʻana i ke kauka:E hālāwai me kāu nephrologist i nā lā i hoʻonohonoho ʻia a e hana i nā hoʻokolohua e pono ai.
- Ka kaohi ʻana i ka maʻi diabetes a me ke koko: Inā loaʻa iā ʻoe ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, e kaohi pono iā lākou.
- E pale i nā lāʻau lapaʻau e hōʻino i nā puʻupaʻa: Mai hoʻomau i ka lawe ʻana i nā lāʻau ʻeha, ʻoiai me ka ʻole o ke aʻo ʻana a ke kauka.
- ʻAi kūpono no nā puʻupaʻa: He mea nui loa kēia. E aʻo ʻia ʻoe e hōʻemi i ka paʻakai (sodium), potassium, e kaupalena i ka ʻai ʻana i ka protein, a ʻai i nā meaʻai haʻahaʻa i ka cholesterol.
- E pale i ka puhipaka.
- Hoʻoikaika Kino: E hoʻoikaika kino no 30 mau minuke i ka lā, ma ka liʻiliʻi he 5 mau lā o ka pule.
- E mālama i ke kaumaha olakino.
Nā lāʻau lapaʻau
Ma muli o kou kūlana, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau like ʻole. Eia kekahi laʻana:
- Nā lāʻau hoʻohaʻahaʻa koko (ACE inhibitors, ARBs).
- ʻO nā diuretics nā lāʻau lapaʻau e wehe i ka wai keu mai ke kino.
- Lāʻau hoʻohaʻahaʻa kolesterol.
- Inā loaʻa iā ʻoe ka anemia, e lawe i nā lāʻau lapaʻau e kōkua ai i ka hana ʻana i nā hunaola koko ʻulaʻula.
- Nā mea e like me ka wikamina D e pale aku ai i ka nāwaliwali o ka iwi.
He aha ka mea e hana ai inā hāʻule loa nā puʻupaʻa (End-Stage Kidney Disease)?
Inā hiki ka maʻi i ke kahua 5, ʻo ia hoʻi ka hāʻule piha ʻana o nā puʻupaʻa, pono ʻoe e hoʻohana i nā ʻano hana ʻē aʻe e ola ai. ʻElua mau koho nui no kēlā.
1. Dialysis: ʻO ka Dialysis ke kaʻina hana o ka hoʻomaʻemaʻe ʻana i ke koko i hiki ʻole i nā puʻupaʻa ke hana me ke kōkua o kahi mīkini.
- Hemodialysis: ʻO kēia kahi e hoʻouna ʻia ai kou koko i kahi mīkini, kahi e wehe ʻia ai nā ʻōpala a laila hoʻihoʻi ʻia i kou kino. Hana pinepine ʻia kēia i ʻekolu manawa i ka pule, no kahi o 4 mau hola i kēlā me kēia manawa.
- ʻO Peritoneal Dialysis: Ma kēia, ua hoʻokomo ʻia kahi wai kūikawā ma o kahi paipu i kau ʻia i loko o kou ʻōpū. Ma hope o ka omo ʻana o ka wai i nā huahana ʻōpala mai kou kino, a laila lawe ʻia ma o ka paipu hoʻokahi. Hiki ke hana ʻia kēia ma ka home, me ka ʻole o ka hele ʻana i ka haukapila.
2. Hoʻoili ʻana o nā puʻupaʻa: Ke pani ʻoki ʻana i kahi puʻupaʻa i hōʻino ʻia me kahi puʻupaʻa olakino. Hiki ke hana ʻia kēia mai kahi kanaka ola (ʻo ka hapa nui he lālā o ka ʻohana) a i ʻole mai kahi kanaka i make (mea hāʻawi kino).
Leka Lawe-Home
- ʻO ka maʻi puʻupaʻa mau loa ka emi mālie ʻana o ka hana o nā puʻupaʻa i ka hala ʻana o ka manawa.
- ʻO ka pilikia nui o kēia, ʻaʻole paha e hōʻike ʻia nā hōʻailona i nā pae mua . No laila, he mea nui loa i ka poʻe me ka maʻi diabetes a me ke koko kiʻekiʻe e nānā mau ʻia ko lākou mau puʻupaʻa.
- ʻOiai ʻaʻole hiki ke ho'ōla loa ʻia ka maʻi,Hiki ke kāohi ʻia ka hōʻino ʻana i nā puʻupaʻa me ka mālama kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona.
- E hahai pono i nā ʻōlelo a kāu kauka . E lawe pono i kāu lāʻau lapaʻau, e kāohi i kāu ʻai, a e hoʻoikaika kino.
- Mai makaʻu i ka ʻike ʻana ua loaʻa iā ʻoe kēia maʻi. Me ka mālama pono ʻana, hiki iā ʻoe ke ola i kahi ola maʻamau. Eia kekahi, e kiʻi i ke kākoʻo o kou ʻohana a me kou mau hoaaloha.
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