Ke makewai mau nei ʻoe a ke kahe nui nei i ka mimi? E kamaʻilio kākou e pili ana i ka Nephrogenic Diabetes Insipidus.

Ke makewai nei hoʻi ʻoe i ka lā a pau? ʻAʻohe mea nui ka nui o ka wai āu e inu ai, manaʻo mau ʻoe ʻaʻole lawa? Pono nō hoʻi ʻoe e mimi pinepine a nui? Manaʻo paha ʻoe he mea maʻamau kēia, a manaʻo paha ʻoe he maʻi diabetes. Eia nō naʻe, hiki i kēia ke lilo i hōʻailona o kahi maʻi lapaʻau kakaʻikahi i kapa ʻia ʻo 'Nephrogenic Diabetes Insipidus'. E kamaʻilio maʻalahi kākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka Nephrogenic Diabetes Insipidus?

I ka ʻōlelo maʻalahi, ʻo ka nephrogenic diabetes insipidus kahi kūlana i hiki ʻole ai i kou mau puʻupaʻa ke hoʻoponopono pono i ka nui o ka wai i loko o kou kino. Hoʻopuka ko mākou kino i kahi hormone i kapa ʻia ʻo Antidiuretic Hormone, a i ʻole ADH no ka pōkole. Ua kapa pū kekahi poʻe iā ia ʻo Vasopressin. ʻO kēia hormone, ADH, "haʻi" i ko mākou mau puʻupaʻa i ka nui o ka wai e hoʻokuʻu ʻia i loko o ka mimi a me ka nui e mālama ʻia i loko o ke kino.

ʻAʻole pane pono nā puʻupaʻa o ke kanaka me ka nephrogenic diabetes insipidus i kēia hormone ADH. ʻO ia hoʻi, ʻoiai ke hāʻawi nei ka hormone ADH i kahi hōʻailona e "paʻa i ka wai a hoʻēmi i ka mimi," ʻaʻole hoʻolohe nā puʻupaʻa iā ia. ʻO ka mea e hana ʻia a laila, ʻo ia ka hana ʻana o nā puʻupaʻa i ka mimi ma mua o ka mea e pono ai. Hiki i kēia ke alakaʻi koke, i kekahi manawa weliweli, i ka maloʻo ʻana o ka wai, ʻo ia hoʻi, ka nele o ka wai.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole maopopo loa i nā kānaka ʻepekema i ka nui o ka poʻe i loaʻa i ka nephrogenic diabetes insipidus, akā manaʻoʻiʻo lākou he maʻi kakaikahi loa ia. ʻO ia hoʻi, ʻaʻole ia he maʻi e loaʻa i nā kānaka a pau.

Aia kekahi mau ʻano like ʻole o ka maʻi diabetes insipidus?

ʻAe, ʻehā ʻano o ka maʻi diabetes insipidus. E nānā kākou i ke ʻano o lākou:

• ʻO ka Central Diabetes Insipidus: Hana ʻia kēia ke hōʻino ʻia ka pituitary gland a i ʻole hypothalamus i loko o kou lolo. ʻO kēia nā ʻāpana e hana, mālama, a hoʻokuʻu i ka hormone ADH. Pale kēia hōʻino i ke kino mai ka hoʻoponopono maʻamau ʻana i ka ADH.
• ʻO ka Nephrogenic Diabetes Insipidus: Ma kēia ʻano maʻi diabetes a mākou e kamaʻilio nei i kēia lā, ʻaʻole hiki i nā puʻupaʻa ke pane pono i ka hormone ADH. ʻOiai aia ka hormone ADH, me he mea lā ua hoʻowahāwahā nā puʻupaʻa iā ia.
• ʻO ka Dipsogenic Diabetes Insipidus: Ua kapa ʻia hoʻi ʻo 'Primary Polydipsia', ua hana ʻia kēia e kahi hemahema i ka ʻōnaehana kaohi makewai i loko o kou hypothalamus. ʻO kēia ke kumu e makewai nui ai ʻoe, manaʻo i ka pono e inu pinepine i ka wai , a mimi nui.
• ʻO ka maʻi diabetes insipidus gestational: Hana wale kēia i ka wā hāpai. I kekahi manawa, hoʻopau kahi enzyme i hana ʻia e ka placenta i ka hormone ADH. Nalo kēia ma hope o ka hānau ʻana o ke pēpē.

He aha ka ʻokoʻa ma waena o ka Nephrogenic Diabetes Insipidus a me ka Diabetes Mellitus?

He mea nui loa kēia e huikau ai ka poʻe he nui. Ke lohe mākou i ka huaʻōlelo "diabetes," manaʻo mākou i ke kō, ʻo ia hoʻi ka maʻi diabetes mellitus. Eia nō naʻe, ʻoiai ua like kekahi o nā hōʻailona o ka nephrogenic diabetes insipidus a me ka maʻi diabetes mellitus (e like me ka mimi nui a me ka makewai nui), ua ʻokoʻa loa kēia mau maʻi ʻelua.

ʻO ka maʻi diabetes mellitus kahi maʻi maʻamau. Hoʻokumu ʻia ia e ka nele o ka hormone insulin a i ʻole ke kino e hoʻohana pono ʻole ana i ka insulin, ka mea e hoʻoulu ai i ke kiʻekiʻe o ke kō koko. Eia nō naʻe, ʻo ka nephrogenic diabetes insipidus kahi pilikia e kū mai ana i ka wā ʻaʻole pane nā puʻupaʻa i ka hormone ADH a ʻaʻohe ona pili me nā pae kō koko . No laila, ʻoi aku ka maikaʻi o ka huikau ʻole ʻana i nā mea ʻelua, ʻeā?

He aha nā kumu o ka Nephrogenic Diabetes Insipidus?

ʻO ko kākou mau puʻupaʻa ke kuleana no ke kānana ʻana i ke koko a me ka wehe ʻana i nā ʻōpala a me ke wai keu mai ke kino ma ke ʻano he mimi. Kōkua ka hormone ADH (vasopressin) i ka mālama ʻana i ke kaulike ma waena o ka nui o ka wai a kākou e inu ai a me ka nui o ka mimi a kākou e hoʻokuʻu aku ai.

E noʻonoʻo, i ka wā e hou nui ai ke kanaka olakino a inu iki paha i ka wai, piʻi aʻe nā pae ADH, e haʻi ana i nā puʻupaʻa e 'hana i ka mimi liʻiliʻi, mālama i ka wai i loko o ke kino.' Pēlā nō, i ka wā e lawa ai ka wai i loko o ke kino, emi iho nā pae ADH, e haʻi ana i nā puʻupaʻa e 'ua maikaʻi, e hana wale i ka mimi i kēia manawa.'

Eia nō naʻe, inā ʻaʻole pane pono kou kino i ka ADH, hana nui kou mau puʻupaʻa i ka mimi. ʻO kēia ka mea e hana ʻia ma ka nephrogenic diabetes insipidus. Hiki ke hoʻoilina ʻia kēia ʻano (hereditary) a i ʻole hiki ke ulu i kēlā me kēia manawa o kou ola (i loaʻa) .

ʻO ka maʻi diabetes nephrogenic insipidus i loaʻa

ʻO kēia ke ʻano maʻamau. Hana ʻia ia ke hoʻopilikia kekahi mea i ka hiki o ke kino ke pane i ka ADH. No ka laʻana, hiki ke hana ʻia e kekahi mau kūlana e hoʻopilikia i kou mau puʻupaʻa. ʻO ia mau kūlana:

• Amyloidosis - ʻO kēia ka wā e waiho ʻia ai kahi protein ʻano ʻē i loko o nā ʻōpū e like me nā puʻupaʻa.
• Kekahi mau ʻano maʻi kanesa
• Maʻi puʻupaʻa mau loa
• Nā maʻi puʻupaʻa, no ka laʻana, pyelonephritis
• ʻO ka maʻi puʻupaʻa polycystic - ʻO kēia ka wā e hana ʻia ai nā cysts piha i ka wai i loko o nā puʻupaʻa.
• ʻŌpū hūpē medullary

Aia kekahi mau kumu ʻē aʻe e pili ana i kēia:

• ʻO kekahi mau lāʻau lapaʻau: ʻOi aku ka lithium (hoʻohana ʻia no kekahi mau maʻi noʻonoʻo) ke hoʻohana ʻia no ka wā lōʻihi.
• Ka haʻahaʻa o ka potassium i loko o ke koko (hypokalemia)
• Hoʻonui ʻia ka nui o ka calcium i loko o ke koko (hypercalcemia)
• ʻAʻai anemia cell sickle
• ʻO ka maʻi Sjögren - He maʻi kēia o ka ʻōnaehana pale.
• Ka ālai ʻana o ke ala mimi - no ka laʻana, kahi mea e like me ka pōhaku mimi.

ʻO ka maʻi diabetes nephrogenic insipidus hoʻoilina

Hoʻokumu ʻia kēia e nā mutations i loko o nā genes AVPR2 a i ʻole AQP2. Hōʻike kēia mau genes i ke kino i ka nui o ka wai e hoʻohui i ka mimi. Ke hemahema kēia mau genes, ʻaʻole hiki i nā puʻupaʻa ke pane i ka ADH. ʻO nā hōʻailona o ka nephrogenic diabetes insipidus, he congenital, e ʻike pinepine ʻia i loko o nā mahina mua o ke ola .

He aha nā hōʻailona o ka Nephrogenic Diabetes Insipidus?

E noʻonoʻo, ua ʻike ʻoe i kekahi, e ʻōlelo kākou ʻo Sumana. Ua makewai nui ʻo Sumana i ka lā a pau. Hana ʻo ia me kahi ʻōmole wai nui kokoke. Akā i loko o hoʻokahi hola o ka inu ʻana, ua makewai hou ʻo ia, a pono nō hoʻi ʻo ia e hele pinepine i ka lua, a mimi nui ʻo ia. I kekahi manawa ala ʻo ia i ʻelua a ʻekolu paha manawa i ka pō e mimi. Ua manaʻo ʻo ia, 'Malia paha no ka mea ke inu nui nei au i ka wai.' Akā ʻo kēia nā hōʻailona nui o ka nephrogenic diabetes insipidus.

Hiki i kekahi kanaka me ka nephrogenic diabetes insipidus ke loaʻa nā hōʻailona e like me:

• Nā hōʻailona o ka make wai: Waha maloʻo, lehelehe māwae, luhi loa, manaʻo poniuniu, a i kekahi manawa polū nā maka i ke kū ʻana. E noʻonoʻo e like me ke noho ʻana i ka lā no ka manawa lōʻihi me ka ʻole o ka wai.
• Polydipsia: Manaʻo ʻoe ʻaʻole lawa ka wai me ka nānā ʻole i ka nui o kāu inu ʻana.
• Ka mimi nui ʻana (Polyuria): Inā mimi kahi pākeke ma mua o 3 lita i ka lā (maʻamau ma waena o 5-20 lita!), A inā mimi kahi keiki ma mua o 2 lita i ka lā, he mea kānalua ia. He māmā loa ke kala o ka mimi, e like me ka wai.

Inā loaʻa i kahi pēpē ʻōpiopio kēia ʻano, hiki iā lākou ke hōʻike i nā hōʻailona e like me kēia no ka mea ʻaʻole lākou maopopo pehea e kamaʻilio ai:

• Ka maʻi pākī
• ʻAʻole e ulu pono a piʻi ke kaumaha - ʻAʻole e piʻi ke kaumaha a ʻaʻole e ulu ke kiʻekiʻe ma mua o nā pēpē ʻē aʻe.
• Kuni pinepine
• Ka hoʻomaha mau a me ka uē ʻana (Irritability) - me he mea lā ua pilikia ka pēpē.
• Ka nalowale o ka makemake, ka emi ʻana o ka lawe ʻana i ka waiū
• Nā ʻūlū - He hōʻailona weliweli kēia.
• Ka luaʻi ʻana
• Pono e hoʻololi pinepine i nā diaper pulu.

Pehea e ʻike ʻia ai ka maʻi diabetes insipidus nephrogenic?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​ʻo ka mea mua āu e hana ai, ʻo ia ke ʻike i ke kauka. E nīnau ʻo ia iā ʻoe i nā nīnau, e nānā iā ʻoe, a, inā pono, e kauoha i nā hoʻokolohua e like me:

• Nā hoʻāʻo koko: E nānā i ka pae o nā electrolytes, e like me ka sodium, i loko o ke kino, a me ka hana o nā puʻupaʻa.
• Nā hoʻāʻo mimi:E nānā i ka nui o ka mimi (pehea kona hoʻoheheʻe ʻia), a me nā mea i loko o ka mimi.
• Hoʻāʻo nele wai: ʻO kēia ka mea e pili ana i ka inu ʻole ʻana i kekahi wai no kekahi mau hola, a laila e nānā i kou kaumaha, ka mimi i hoʻopuka ʻia, a me ke koko a me ka nui o ka mimi i kēlā me kēia hola. He hoʻāʻo paʻakikī kēia, akā he mea nui loa ia no ka ʻike ʻana. ʻO kēia wale nō ke ala e hoʻoholo pololei ai inā e pane ana nā puʻupaʻa i ka ADH. Hana ʻia kēia hoʻāʻo ma lalo o ka nānā ʻana o ke kauka ma kahi haukapila.
• Ke hoʻāʻo ʻana me ka hormone ADH: I kekahi manawa, hāʻawi ʻia ka hormone ADH ma ke ʻano he inikini me ka hoʻāʻo nele i ka wai, a laila nānā ʻia inā loli ka nui o ka mimi. I ka nephrogenic diabetes insipidus, ʻoiai inā hāʻawi ʻia ka ADH, ʻaʻole nui ka loli o ka nui o ka mimi.
• ʻO ke kiʻi MRI o kāu kelepa pituitary (Magnetic resonance imaging): Inā kānalua ʻoe i kahi kūlana e like me ka diabetes insipidus waena, e nānā i nā mea ʻē aʻe i loko o ka lolo.
• Ka hoʻāʻo ʻana i ka hoʻoilina: Inā loaʻa kekahi o kou ʻohana i ka maʻi diabetes insipidus, a inā paha ʻoe e manaʻo he ʻano hoʻoilina ia.

Aia kekahi lāʻau lapaʻau piha no ka Nephrogenic Diabetes Insipidus?

I ka ʻoiaʻiʻo, ʻaʻohe lāʻau lapaʻau piha no ka nephrogenic diabetes insipidus i kēia manawa.

Akā, mai hopohopo. Hiki ke mālama ʻia. Hiki paha i kāu kauka ke hoʻololi i nā lāʻau lapaʻau āu e lawe nei e hoʻoulu ai i ka pilikia (e like me ka lithium). Eia kekahi, inā he maʻi ʻē aʻe (e like me ka maʻi puʻupaʻa a i ʻole ka calcium/potassium imbalance), ʻo ka mālama pono ʻana iā ia i kekahi manawa hiki ke hoʻohuli a kāohi paha i ka nephrogenic diabetes insipidus.

No laila pehea ʻoe e mālama ai i kēia?

I nā hihia kahi i hiki ʻole ai ke hoʻihoʻi ʻia (no ka laʻana, hānau ʻia), ʻo ke kumu nui o ka mālama ʻana ʻo ia ka pale ʻana i ka maloʻo ʻana o ka wai a me ka mālama ʻana i kahi ola maikaʻi. Hiki i kēia ke komo pū me:

• E inu mau i ka wai: ʻO kēia ka mea nui loa. Pono ʻoe e inu i ka wai i ke ao holoʻokoʻa, i ka wā e make wai ai ʻoe. E hōʻoia e inu i ka wai hou aku, ʻoiai i nā lā wela, i ka wā e hoʻoikaika kino ai, a i ʻole i ka wā e hou ana ʻoe. E mālama i kahi ʻōmole wai kokoke i ka pō.
• Nā loli i ka ʻai:
• ʻAi paʻakai haʻahaʻa: ʻO ka ʻai ʻana i ka paʻakai nui loa e hoʻonui ai i ka make wai a me ka mimi ʻana.
• ʻAi haʻahaʻa protein: I kekahi manawa e ʻōlelo ʻia paha ʻoe e kaupalena i ka protein, no ka mea, pono nō hoʻi ka wai e hoʻokahe i nā huahana ʻōpala i hana ʻia i ka wā o ka ʻeli ʻana o ka protein.
• Nā lāʻau lapaʻau e hōʻemi ai i ka hoʻopuka ʻana o ka mimi:
• Nā lāʻau diuretic Thiazide:ʻO ka mea kupanaha, ʻo kēia mau diuretics, ke hāʻawi ʻia i ka poʻe me ka nephrogenic diabetes insipidus, e hōʻemi maoli i ka nui o ka mimi a lākou e hana ai. He mea paʻakikī iki ia, akā he mea pono ia.
• ʻAmiloride: Hiki ke hāʻawi ʻia i ka hui pū ʻana me nā thiazides, ʻoi aku hoʻi no ka NDI i hoʻokumu ʻia e ka lithium.
• Nā Lāʻau Lapaʻau Anti-Inflammatory Nonsteroidal (NSAIDs): No ka laʻana, indomethacin. Kōkua kēia i ka hoʻolilo ʻana i nā puʻupaʻa i mea ʻoi aku ka maʻalahi i ka ADH.

He aha nā meaʻai a me nā mea inu e pono ai i kekahi me kēia maʻi ke pale aku?

Hiki i kāu kauka ke ʻōlelo aku iā ʻoe e kaupalena i ka waiʻona, nā mea inu caffeine (e like me ke kofe, ke kī, a me kekahi mau mea inu palupalu), nā meaʻai paʻakai (e like me nā pickles, nā ʻiʻo maloʻo, nā sausage, a me nā ʻuala palai), a me nā meaʻai protein kiʻekiʻe paha, no ka mea hiki i kēia mau mea ke hoʻolilo i kou kino i ka wai hou aʻe a hoʻonui i kāu lawe ʻana i ka wai.

Aia kekahi mau ala e pale aku ai i ka Nephrogenic Diabetes Insipidus?

ʻAʻohe hoʻolālā i hōʻoia ʻia e pale aku i kēia. ʻOi aku ka ʻano hānau ʻole ʻaʻole hiki ke pale ʻia. Eia naʻe, no ke ʻano i loaʻa:

• Inā ʻoe e lawe nei i nā lāʻau lapaʻau e hiki ai ke hoʻoulu i ka NDI, e like me ka lithium, he mea nui e kamaʻilio me kāu kauka e pili ana i ia mea a e nānā pinepine ʻia kāu hana puʻupaʻa.
• Hiki ke hoʻēmi ʻia ka pilikia ma ka mālama koke ʻana a me ka mālama pono ʻana i nā pilikia olakino ma lalo (maʻi puʻupaʻa, nā hemahema electrolyte).

Inā loaʻa iaʻu kēia maʻi, he aha kaʻu e manaʻo ai?

ʻO kēia ka nūhou maikaʻi loa. Me ka mālama kūpono a me ke ʻano olakino , ʻoi aku ka liʻiliʻi o nā pilikia nui o ka poʻe me ka nephrogenic diabetes insipidus a hiki ke ola i kahi ola maʻamau. Hiki iā ʻoe ke hana a hauʻoli i ke ola e like me ka maʻamau.

Eia nō naʻe, inā ʻaʻole mālama pono ʻia, hiki i kēia ke alakaʻi i nā pilikia koʻikoʻi. E nānā kākou i ke ʻano o lākou:

• Ka maloʻo ʻana o ka wai: ʻO kēia ka pilikia maʻamau a koʻikoʻi loa. Hiki i ka maloʻo nui ke alakaʻi i ka nalowale o ka ʻike, nā hopu ʻana, a me ka hāʻule ʻana o nā puʻupaʻa.
• Ka haunaele o ka electrolyte: He loli kēia i ka nui o nā electrolytes (e like me ka sodium a me ka potassium) i loko o ke kino. Hiki i kēia ke hoʻopilikia i ka helu o ka puʻuwai a me ka hana aʻalolo.
• Nā maʻi: Nā mea e like me nā maʻi urinary tract (UTI) a me nā maʻi puʻupaʻa.
• Ka lohi o ka ulu ʻana, ka hōʻino ʻana o ka lolo a me ke kīnā noʻonoʻo i nā pēpē. He mea weliweli loa kēia no nā keiki ʻōpio. No laila, inā loaʻa i kahi pēpē kēia mau hōʻailona, ​​​​pono e hoʻomaka koke i ka lāʻau.
• Ka hāʻule ʻana o nā puʻupaʻa: Hiki ke hana i ka wā lōʻihi inā ʻaʻole i kaohi pono ʻia.
• Hydronephrosis: Ma muli o ka piha mau ʻana o ka ʻōpū mimi, hoʻihoʻi ʻia ka mimi a pehu nā puʻupaʻa.

Āhea ʻoe e ʻimi ai i ke aʻo lapaʻau?

Inā he kānalua a hopohopo paha kāu e pili ana i ka nui o ka mimi āu e hoʻomoe nei, ʻoiai inā he nui kou mimi me ka mimi nui ʻana, e ʻike pono i ke kauka.

Hiki ke ʻokoʻa ka nui o ka mimi a kekahi kanaka makua e hoʻokuʻu ai i kēlā me kēia lā mai kēlā kanaka a kēia kanaka, ʻoiai ma muli o ka nui o ka wai a lākou e inu ai. Akā inā ʻoe e mimi ana ma mua o 2-3 lita i kēlā me kēia lā (ʻōlelo kekahi mau wehewehe ʻoi aku ma mua o 3 lita), a inā ʻoe e mimi pinepine ana (ʻoi aku ma mua o ʻehiku a ʻewalu paha manawa i ka lā) , he hōʻailona paha ia o kahi pilikia.

Ma mua o ke kipa ʻana i ke kauka, he mea kōkua nui ka mālama ʻana i kahi puke moʻolelo o ka nui o ka wai āu e inu ai a me ka nui o ka mimi āu e hana ai (e ana ʻia inā hiki). E maʻalahi kēia i ke kauka ke hoʻomaopopo i kou kūlana.

No laila, he aha nā mea e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo? (Leka Lawe-Home)

ʻO ka Nephrogenic Diabetes Insipidus kahi maʻi laha ʻole kahi e pane pono ʻole ai kou mau puʻupaʻa i ka hormone ADH i loko o kou kino, e hoʻoulu ai iā ʻoe e hana i ka nui o ka mimi. Hiki i kēia ke alakaʻi i ka maloʻo koke.

• ʻO nā hōʻailona nui , ka make wai nui a me ka mimi nui a wai .
• ʻAʻole pono e huikau kēia me ka maʻi diabetes mellitus; i kēia hihia, he maʻamau ke kiʻekiʻe o ke kō koko.
• Hiki ke loaʻa kēia ʻano i ka wā hānau a i ʻole e ulu aʻe ma hope o ke ola.
• ʻOiai ʻaʻohe lāʻau lapaʻau piha, me ka mālama pono ʻana i nā lāʻau lapaʻau a me nā hoʻololi ʻana i ke ʻano o ka nohona (ʻoi aku ka inu ʻana i ka wai lawa a me ka kaohi ʻana i kāu ʻai), hiki iā ʻoe ke ola i kahi ola maʻamau a olakino.
• Inā kānalua ʻoe ua loaʻa iā ʻoe a i ʻole kāu keiki kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau. Mai hopohopo, akā ʻo ka mea nui loa, ʻo ia ka hoʻomaopopo ʻana a me ka hana ʻana i nā hana e pono ai. ʻAʻole ʻoe hoʻokahi, a hiki i nā kauka ke kōkua iā ʻoe.

ʻO ka maʻi diabetes insipidus nephrogenic, maʻi puʻupaʻa, mimi nui, makewai nui, ADH, vasopressin, maloʻo