Ua noʻonoʻo paha ʻoe no ke aha i kekahi manawa he kiʻekiʻe aʻe kekahi mau mea i loko o ko kākou kino ma mua o ka mea e pono ai? Malia paha ua haʻi aku kekahi kauka iā ʻoe he nui loa kou phosphate i loko o kou koko. A i ʻole ua lohe paha ʻoe e pili ana i ia mea ma kekahi wahi. ʻO kēia ka mea a mākou e kapa nei he hyperphosphatemia. ʻOiai paha he mea ʻē iki ka inoa, inā maopopo pololei iā mākou, ʻaʻohe mea e hopohopo ai.
He aha maoli ka hyperphosphatemia?
I ka ʻōlelo maʻalahi, ʻo ka hyperphosphatemia ka wā e loaʻa ai i kou koko ka nui o ka mineral i kapa ʻia ʻo phosphate. He meaʻai koʻikoʻi ka phosphate no ko mākou kino. Kōkua ia i ka mālama ʻana i ko mākou mau iwi a me nā niho i ikaika, hāʻawi i ka ikehu no ko mākou mau cell, a kōkua i ka hana ʻana i nā membrane cell.
E noʻonoʻo i kēia ʻano, ua like ka phosphate me kahi pila liʻiliʻi i loko o ko kākou kino. I mea e hana pono ai kēia mau mea, pono lākou i kahi uila. ʻO ka Phosphate kekahi o ia mau electrolyte . ʻO nā electrolytes nā minelala hiki ke lawe i kahi uila maikaʻi (+) a i ʻole maikaʻi ʻole (-) ke hoʻoheheʻe ʻia i loko o ka wai a i ʻole kahi wai e like me ko kākou koko. No laila, ʻo ka mālama ʻana i kēia pae phosphate kaulike he mea nui ia no nā hana he nui i loko o ke kino. Maopopo iā ʻoe?
ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?
ʻOiaʻiʻo, hiki i kekahi ke loaʻa i kēia maʻi i kapa ʻia ʻo hyperphosphatemia. Eia nō naʻe, ʻoi aku ka maʻamau i nā poʻe me nā pilikia puʻupaʻa. ʻOi aku ka maʻamau, ʻo ka poʻe me ka maʻi puʻupaʻa mau loa (CKD) , ʻoiai ka poʻe me ka maʻi holomua, a i ʻole ka poʻe me ka hāʻule ʻana o ka puʻupaʻa, ʻoi aku ka nui o ka loaʻa ʻana o kēia maʻi.
I kēia manawa, aia kekahi mau mea e hiki ke kōkua i ka maʻi puʻupaʻa. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau mea, aia ʻoe i kahi pilikia iki o ka loaʻa ʻana o ka maʻi puʻupaʻa a, ma o ia mea, hyperphosphatemia:
- Inā loaʻa iā ʻoe ka maʻi diabetes (Diabetes Mellitus) .
- Inā he koko kiʻekiʻe kou (hypertension) .
- Inā he maʻi puʻuwai kou .
- Inā ua loaʻa i kekahi o kou ʻohana ka maʻi puʻupaʻa (ʻo ia hoʻi, he maʻi hoʻoilina paha ia).
- Inā he mea ʻē aʻe i ke ʻano o kou mau puʻupaʻa.
- Inā he ʻApelika ʻAmelika ʻoe, Hispanic, ʻĀkia, a i ʻole ʻAmelika ʻōiwi (ʻoi aku ka nui o ka poʻe o kēia mau lāhui e loaʻa i nā maʻi puʻupaʻa).
- Inā ʻoe ma luna o 60 mau makahiki .
- Inā ʻoe he mea hoʻohana pinepine i nā lāʻau hōʻoluʻolu ʻeha no ka manawa lōʻihi , ʻoiai nā lāʻau anti-inflammatory nonsteroidal (NSAID), hiki ke kūʻai ʻia ma luna o ke kūʻai ma ka hale kūʻai lāʻau.
Pehea ka maʻamau o kēia ʻano?
Inā ʻoe e nānā i ka hapa nui o ka poʻe ma ka honua, he mea kākaʻikahi loa ka loaʻa ʻana o ka hyperphosphatemia wale nō. ʻO ia hoʻi, he piʻi wale nō ka phosphate i loko o ke koko. Akā, e like me kaʻu i ʻōlelo ai ma mua, inā loaʻa iā ʻoe ka maʻi puʻupaʻa mau loa , ʻoiai inā he koʻikoʻi, he mea maʻamau loa kēia ʻano. Ma ke ʻano laulā, ma kahi o 70% o ka poʻe me ka maʻi puʻupaʻa mau loa ua ʻike ʻia he hyperphosphatemia.
He aha ka mea e hana ʻia i ke kino ke piʻi aʻe ka nui o ka phosphate?
Ua kamaʻilio mua mākou e pili ana i ke ʻano o ka phosphate e hoʻoikaika ai i ko mākou mau iwi a me nā niho, hāʻawi i ka ikehu no nā cell, a kōkua i ke kūkulu ʻana i nā membrane cell. He ʻoiaʻiʻo kēlā. Akā, e like me nā mea āpau, ʻo ka nui o ia mea hiki ke hoʻoulu i nā pilikia.
E noʻonoʻo, inā piʻi nui ka pae phosphate i loko o kou koko, hoʻomaka ia e hoʻokuʻu i ka calcium mai kou mau iwi. He aha ka mea e hana ʻia a laila? Lilo nā iwi i nāwaliwali a palupalu.
ʻAʻole wale ia, akā hiki i kēia phosphate keu ke hana i nā waihona calcium i loko o kou mau maka, nā māmā, ka puʻuwai, a me nā kīʻaha koko. He mea weliweli iki kēia. No ka mea, i ka hala ʻana o ka manawa, hoʻonui kēia mau waihona i kou pilikia o ka hōʻeha puʻuwai, nā hahau , a me ka make.
He aha nā hōʻailona o ka Hyperphosphatemia?
ʻO ka hapa nui o ka manawa, ke loaʻa iā ʻoe ka hyperphosphatemia wale nō, ʻaʻole ʻoe e ʻike i kekahi mau hōʻailona nui. ʻO ia hoʻi, ʻaʻole paha ʻoe e ʻike i ka wā mua he nui loa ka phosphate i loko o kou kino. Eia naʻe, e like me kā mākou i kūkākūkā ai, i ka wā e piʻi ai kēia phosphate, hiki iā ia ke lilo i ka calcium mai kou mau iwi a me ke koko. Ua kapa ʻia kēlā he hypocalcemia . ʻO ia hoʻi ka emi ʻana o ka pae o ka calcium i loko o ke koko.
No laila, ʻo ka hapa nui o ka manawa, ua like nā hōʻailona o ka hyperphosphatemia me nā mea i hoʻokumu ʻia e ka hypocalcemia. E nānā inā kamaʻāina kēia mau mea iā ʻoe:
- ʻŌpū ʻiʻo.
- Nā kui palupalu.
- ʻIli maloʻo.
- ʻOi aku ka mānoanoa o ka lauoho ma mua o kou lauoho maʻamau.
- Nā pilikia hoʻomanaʻo .
- Hoʻonāukiuki.
- Ke ʻūlū nei ma nā lehelehe, ke alelo, nā manamana lima, a me/a i ʻole nā wāwae.
- I kekahi manawa hele mai ia e like me ka maʻi (nā kuʻi).
- Nā mea ʻino i loko o ka puʻuwai, ʻo ia hoʻi, ka arrhythmia.
No ke aha e kū ai ka hyperphosphatemia?
Aia paha kekahi mau kumu no kēia. ʻO nā mea nui:
- ʻO ka maʻi puʻupaʻa mau loa. ʻO kēia ke kumu maʻamau. Ke hana pono ʻole nā puʻupaʻa, ʻaʻole hiki iā lākou ke hoʻokuʻu i ka phosphate keu mai ke kino.
- Hypoparathyroidism. He kūlana kēia kahi e hana ai nā kelepa parathyroid i ka hormone parathyroid liʻiliʻi loa, ka mea e kaohi ai i nā pae calcium a me phosphate o ke kino.
- ʻOi aku ka haʻahaʻa o kou pH koko ma mua o ka maʻamau (ʻo ia hoʻi, ʻoi aku ka waikawa o kou koko). Malia paha kēia no ka mea ʻaʻole hiki i kou mau māmā ke hoʻopau i nā kalapona ʻokikene āpau i hana ʻia i loko o kou kino. Ua kapa ʻia kēia he acidosis hanu .
- ʻO ka emi ʻana o ka pH koko ma muli o nā kumu ʻē aʻe ( metabolic acidosis ).
Ma waho aʻe o kēia mau mea, ʻoiai ʻaʻole i maʻamau, hiki ke hana ʻia ka hyperphosphatemia ma muli o nā kumu penei:
- ʻO ke ketoacidosis e pili ana i ka maʻi diabetes.
- Ka hōʻino ʻana o nā ʻiʻo ( rhabdomyolysis ).
- Ka maʻi koʻikoʻi ( sepsis ).
- ʻEha paʻi (nā ʻeha i hana ʻia e ka hāʻule ʻana o kahi mea kaumaha ma luna o ke kino a i ʻole e ke kaomi ʻana o kahi mea ma luna o ke kino no ka manawa lōʻihi).
- ʻAʻole pane pono kou kino i ka hormone parathyroid ( pseudohypoparathyroidism ).
- Ke loaʻa ʻana o ka nui o ka phosphate i loko o kou kino, mai ka meaʻai āu e ʻai ai a i ʻole ma o ka enema .
He aha ke kumu maʻamau?
E like me kaʻu i ʻōlelo ai ma mua, ʻo ke kumu nui a me ka mea maʻamau o ka hyperphosphatemia ka maʻi puʻupaʻa mau loa.
He maʻi lele anei kēia?
ʻAʻole, ʻaʻole he maʻi lele ka hyperphosphatemia. ʻAʻole hiki iā ʻoe ke hoʻolaha iā ia i nā poʻe ʻē aʻe. Eia nō naʻe, he mea kakaikahi loa, hiki ke holo i loko o nā ʻohana ma muli o nā kumu genetic.
Pehea e ʻike ai nā kauka i kēia?
Hiki i ke kauka ke haʻi inā he hyperphosphatemia kou. E lawe ʻo ia i kāu mōʻaukala olakino , e hana i kahi hoʻokolokolo kino , a e nīnau e pili ana i kāu mau hōʻailona, kāu ʻai, a me nā lāʻau lapaʻau āu e lawe ai. No ka ʻike pono ʻana i kāu mau pae phosphate, pono ʻoe e hana i kahi hoʻāʻo koko .
I ka wā o ka hoʻāʻo koko, e lawe ke kauka a kahu maʻi paha i kahi koko liʻiliʻi mai kahi aʻa koko ma kou lima me ka hoʻohana ʻana i kahi nila liʻiliʻi (21 gauge, ʻoi aku ka liʻiliʻi ma mua o ka piko o kahi apo pepeiao maʻamau). Hoʻouna ʻia kēia hāpana koko i kahi keʻena hoʻokolohua e nānā i ka nui o ka phosphate i loko o kou koko. Inā ʻoi aku kou pae phosphate ma mua o 4.5 milligrams no ka deciliter (4.5 mg/dL) o ke koko,, ʻo ia hoʻi, he hyperphosphatemia kou.
Inā ua ʻike ʻia ʻoe me kēia maʻi, hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aʻe e nānā i ke kūlana o kou mau puʻupaʻa. Hiki i kēia mau mea ke komo pū me:
- Nā hoʻāʻo koko hou aʻe.
- He hoʻāʻo no ka nānā ʻana i ka protein i loko o ka mimi.
- He nānā ʻana i ka ultrasound .
- He kiʻi MRI .
- Kiʻi CT .
- ʻO ka biopsy puʻupaʻa ( lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo puʻupaʻa no ka hoʻokolokolo ʻana).
He aha nā lāʻau lapaʻau no kēia?
ʻO ka mālama ʻana no ka hyperphosphatemia e pili ana i ke kumu o ka hōʻiliʻili ʻana o ka phosphate i loko o kou koko. Hiki i kekahi mau meaʻai a me nā lāʻau lapaʻau ke hoʻoulu i nā pae phosphate kiʻekiʻe. Inā hana kēia, pono paha ʻoe e kaupalena a hoʻōki paha i ka ʻai ʻana i kekahi mau meaʻai a lāʻau lapaʻau paha. A i ʻole, pono paha ʻoe e hoʻololi i kahi lāʻau lapaʻau ʻē aʻe me nā pae phosphate haʻahaʻa.
ʻO ka mea nui loa, ʻo ia ka hahai pono ʻana i nā ʻōlelo a ke kauka.
Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e hōʻemi i ka nui o ka phosphate i omo ʻia e kou kino. ʻO ke ʻano kēia, ʻoi aku ka nui o ka phosphate i hoʻokuʻu ʻia i loko o kou mimi (pee). ʻO kēia mau lāʻau lapaʻau:
- Sevelamer (Sevelamer - RenaGel®)
- Lanthanum (Lanthum - Fosrenol®)
- Kalikiuma ʻāseta (Kalikiuma ʻāseta - Calphron®)
Inā kiʻekiʻe kou pae phosphate ma muli o ka hāʻule ʻana o nā puʻupaʻa, e hoʻomaka paha kāu kauka iā ʻoe ma ka dialysis . Hana ʻo Dialysis i ka mea a kou mau puʻupaʻa e hana ai. ʻO ia hoʻi, hoʻoneʻe ia i ka wai keu a me nā huahana ʻōpala, me ka phosphate, mai kou koko.
He aha nā meaʻai i loaʻa ka phosphorus kiʻekiʻe?
Aia kekahi mau meaʻai a me nā mea inu i kiʻekiʻe i ka phosphorus - ka mea i hoʻokumu ʻia ai ka phosphate. He mea nui e makaʻala i kēia mau mea, ʻoiai inā he hyperphosphatemia kou.
- ʻO nā huahana waiū a me nā huahana waiū, e like me ka waiū, nā tīhi i hana ʻia, a me ka yogurt.
- Kekahi mau mea inu kalapona (soda pop/mea inu fizzy).
- Nā ʻiʻo i hana ʻia ( e like me nā sausage a me ka bacon).
- Mea ʻai wikiwiki.
- Nā meaʻai māmā ( nā mea i hoʻopili ʻia e like me nā ʻuala palai, nā biscuits).
- Nā nati.
- ʻO nā palaoa holoʻokoʻa , e komo pū ana me ka palaoa, ka ʻoka, a me ka laiki (ʻoi aku ka poʻe me ka bran).
- Nā pī.
- Nā lentil.
Ua haʻi aku paha kāu kauka iā ʻoeE kuhikuhi ʻia ʻoe i kahi meaʻai renal . ʻO kēia ka poʻe loea i ke ʻano o ka hoʻokele ʻana i kāu papaʻai e kākoʻo i ke olakino o nā puʻupaʻa. E kōkua lākou iā ʻoe e hana i kahi hoʻolālā papaʻai kūikawā (ʻai renal) e kaupalena ana i ka nui o ka phosphate i loko o kou kino.
Aia kekahi ala e pakele ai i kēia kūlana?
ʻO ke ala maikaʻi loa e pale aku ai i ka hyperphosphatemia, ʻo ia ka mālama ʻana i ke olakino o kou mau puʻupaʻa a e makaʻala i ka nui o ka phosphate a me ka calcium āu e hoʻopau nei. Inā manaʻo ʻoe he pilikia paha ʻoe no kēia ʻano, e kamaʻilio me kāu kauka. Hiki iā ia ke kuhikuhi iā ʻoe i kahi nephrologist . He kauka loea ka nephrologist i nā kūlana e hoʻopilikia ai i nā puʻupaʻa.
He aha nā manawa kūpono loa e ʻike ai i ke kauka?
Inā ʻike ʻoe he hyperphosphatemia kou, a loaʻa iā ʻoe nā hōʻailona o ka maʻi puʻupaʻa a i ʻole ka hāʻule ʻana o ka puʻupaʻa, e ʻike koke i ke kauka. Mai hoʻokaʻulua.
He aha nā nīnau āu e nīnau ai i ke kauka?
Ke hele ʻoe e ʻike i ke kauka, he mea nui loa e nīnau i kēia mau nīnau:
- Pehea ʻoe e ʻike pono ai inā loaʻa iaʻu ka hyperphosphatemia?
- Inā ʻaʻohe oʻu maʻi i kēia, he aha nā maʻi olakino ʻē aʻe e loaʻa iaʻu?
- He aha ka pae phosphate koko olakino?
- He aha nā lāʻau lapaʻau āu e ʻōlelo mai ai iaʻu?
- Pono ʻoe i kahi palapala lapaʻau e kiʻi ai i kēlā lāʻau lapaʻau, a i ʻole hiki iā ʻoe ke kūʻai wale ma ka hale kūʻai lāʻau lapaʻau?
- He aha nā meaʻai a me nā mea inu e pono ʻole iaʻu e ʻai a inu paha?
- ʻEhia ka nui o ka phosphorus e ʻai ai au i kēlā me kēia lā?
- Hiki iā ʻoe ke kuhikuhi mai iaʻu i kahi meaʻai renal?
- Pono anei au e ʻike i kahi nephrologist a i ʻole kekahi loea ʻē aʻe?
He aha ka ʻokoʻa ma waena o ka Hyperphosphatemia a me ka Hypocalcemia?
Hiki i kēia mau mea ʻelua ke huikau iki, no laila e wehewehe kākou.
ʻO ka Hyperphosphatemia ka wā e kiʻekiʻe loa ai ka pae phosphate i loko o kou koko.
ʻO ka hypocalcemia ka wā e haʻahaʻa loa ai ka pae calcium i loko o kou koko.
ʻO ka hapa nui o ka manawa, ʻo kēia kūlana i kapa ʻia ʻo hypocalcemia e kū mai ana ma ke ʻano he hopena ʻaoʻao o kekahi kūlana olakino ʻē aʻe. ʻO Hyperphosphatemia kekahi kumu o ka hypocalcemia.
Leka Hoʻihoʻi Hope Loa
ʻAe, ua kamaʻilio nui mākou e pili ana i ka hyperphosphatemia. I ka ʻōlelo maʻalahi, he piʻi ʻana ia o ka pae o ka phosphate i loko o kou koko. ʻOiai ʻaʻole ia he mea maʻamau i ka hapa nui o ka poʻe ma ka honua, hiki ke lilo i mea maʻamau i ka poʻe me ka maʻi puʻupaʻa mau a i ʻole ka hāʻule ʻana o ka puʻupaʻa .
I ka manawa pinepine, ʻaʻohe hōʻailona kikoʻī i ka wā mua. No laila, ʻike wale ka poʻe he nui ua loaʻa iā lākou ke ʻano ma hope o ka ʻike ʻia ʻana o nā hōʻailona ʻē aʻe, e like paha me ka hypocalcemia.
Ke ʻike ʻoe he hyperphosphatemia kou, ʻoiai ke haʻi ʻia aku iā ʻoe e pono ʻoe i ka dialysis, he mea maʻamau ka hopohopo a me ka makaʻu. ʻAʻohe hewa o ka loaʻa ʻana o kēlā mau manaʻo. E kamaʻilio me kāu kauka e pili ana i nā nīnau a hopohopo paha āu. E pane lākou i kāu mau nīnau, e hāʻawi iā ʻoe i ke kākoʻo āu e pono ai, a e hāʻawi iā ʻoe i ka ʻōlelo aʻoaʻo no ke ala maikaʻi loa e kū ai i kēia kūlana. E hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi!
ʻO ka Hyperphosphatemia, Phosphate, Maʻi Pūpū, Maʻi Pūpū Mau, Hypocalcemia, Dialysis
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