Ke hoʻokuʻu nui nei kou mau puʻupaʻa i ka protein? E kamaʻilio kākou e pili ana i ka Nephrotic Syndrome!

Ua hoʻomaka koke anei kou mau wāwae, lima, a i ʻole kou maka e pehu? A i ʻole ua like kou mimi me ke kino o kahi pēpē e pehu ana? Ke nānā aku nei ia me he huʻa ke mimi ʻoe? He pilikia liʻiliʻi paha kēia me kou mau puʻupaʻa, hiki ke kumu o kahi maʻi. I kēia lā e kamaʻilio mākou e pili ana i kekahi maʻi puʻupaʻa, ʻo 'Nephrotic Syndrome'. Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha ka Nephrotic Syndrome?

I ka ʻōlelo maʻalahi, ʻo ka nephrotic syndrome kahi kūlana kahi e hoʻokuʻu nui ai ko mākou mau puʻupaʻa i ka protein i loko o ka mimi. Ua kapa ʻia kēia e nā kauka he "proteinuria". I ka pololei, inā ʻoi aku ma mua o 3 grams o ka protein (ʻoi aku ka kaumaha ma mua o hoʻokahi peni US) i hoʻokuʻu ʻia i loko o ka mimi i kēlā me kēia lā, ʻo ia ka hōʻailona nui o kēia kūlana. He 20 mau manawa kēia ma mua o ka nui i hoʻokuʻu ʻia e nā puʻupaʻa olakino.

I kēia manawa, e noʻonoʻo i ko kākou mau puʻupaʻa e like me ke kānana . He mau kīʻaha koko liʻiliʻi ko kēia kānana, a mākou e kapa nei he `(glomeruli)` . Kānana kēia mau `(glomeruli)` i nā huahana ʻōpala (no ka laʻana, ka ʻōpala nitrogenous `(urea)`, ka ʻōpala ʻiʻo `(creatinine)`, a me nā waikawa), a me ka wai pono ʻole mai ke koko. A laila hoʻokuʻu ʻia lākou ma ke ʻano he mimi. ʻO ka maʻamau, i loko o kahi puʻupaʻa olakino, kānana ka `(glomeruli)` i nā mea e pono ai ke kino, e like me nā protein, a mālama iā lākou i loko o ke koko, ʻoiai ka protein `(albumin)` . Akā i ka wā e hōʻino ʻia ai kēia mau `(glomeruli)`, ʻaʻole lākou e hana pono. A laila, hōʻiliʻili maʻalahi nā protein waiwai e like me `(albumin)` i loko o ka mimi.

He mea hoʻoweliweli anei kēia i ke ola?

ʻAe, he maʻi koʻikoʻi ka maʻi nephrotic. Inā ʻaʻole mālama pono ʻia, hiki iā ia ke alakaʻi i nā pilikia ʻē aʻe a hoʻopilikia i kou ola. No laila, he mea nui loa ia e makaʻala i kēia a e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe nā hōʻailona.

ʻO wai ka mea e loaʻa ana i ka nephrotic syndrome?

Hiki i kekahi ke loaʻa i kēia. Eia nō naʻe, ʻo ka poʻe i loaʻa i ka maʻi puʻupaʻa e pili ana i ka maʻi diabetes, ka poʻe me kekahi mau maʻi allergies, a me ka poʻe me ka mōʻaukala ʻohana o kēia ʻano maʻi puʻupaʻa (me ka nephrotic syndrome) ʻoi aku ka nui o ka loaʻa ʻana iā ia.

ʻAʻole kēia he maʻi maʻamau loa.

• Hoʻopilikia ia ma kahi o 1 i loko o 50,000 mau keiki i kēlā me kēia makahiki. ʻIke pinepine ʻia ia i nā keiki ma waena o 2 a me 5 mau makahiki. ʻOi aku ka pālua o ka loaʻa ʻana o ia ma nā keikikāne ma mua o nā kaikamahine.
• I nā mākua , hana ʻia kēia ma kahi o ʻekolu o kēlā me kēia haneli tausani kānaka i kēlā me kēia makahiki.

Pehea ka hopena o ka maʻi nephrotic i ke kino?

Ke hoʻokuʻu ʻia nā protein, he mea nui loa ia i ko mākou kino, i loko o ka mimi, kū mai nā ʻano pilikia like ʻole.

• Kōkua kekahi mau protein i ka pale ʻana i ke koko mai ka hoʻopili ʻana . Ke nalowale lākou, hiki ke hana ʻia nā ʻūpā koko.
• ʻO kekahi ʻano koʻikoʻi o ka protein`(Immunoglobulins)` . Kōkua kēia i kā mākou ʻōnaehana pale e hakakā i nā maʻi a me nā maʻi. Ke nalowale kēia mau mea, hiki iā mākou ke loaʻa maʻalahi i nā maʻi. Eia kekahi laʻana:
• `(Pneumonia)` (Pneumonia)
• ʻO ka Cellulitis (kahi maʻi bacteria o ka ʻili)
• ʻO Peritonitis (kahi maʻi o ka uhi o ka ʻōpū)

He aha nā hōʻailona o ka maʻi nephrotic?

He mea nui e hoʻolohe pono i kēia mau hōʻailona:

• ʻO ka nui o ka protein `(albumin)` i loko o ka mimi (`(albuminuria)`) : Ua hoʻokuʻu ʻia ma mua o 3.5 grams o ka protein `(albumin)` i kēlā me kēia lā.
• Hoʻonui ʻia ka nui o ka momona a me ka cholesterol i loko o ke koko (hyperlipidemia) .
• Pehu (`(edema)`) : ʻO ka hapa pinepine, pehu nā wāwae, nā kuʻekuʻe wāwae, a me nā wāwae. I kekahi manawa hiki i nā lima a me ke alo ke pehu. E noʻonoʻo, inā ala kāu keiki i ke kakahiaka a ʻike ʻia ka ʻāpana a puni ko lākou mau maka ua pehu, he hōʻailona paha ia o kēia.
• Ua emi ka nui o ka protein albumin i loko o ke koko (hypoalbuminemia) .
• ʻAʻohe ʻono o ka meaʻai .
• Manaʻo luhi a make ke ola i nā manawa a pau .
• ʻEha ʻōpū (ma nā wahi a pau mai nā iwi ʻaoʻao a i ka ʻōpū lalo).
• Mimi huʻa , e like me ka wai kopa.

ʻO kekahi mea ʻē aʻe, ua nalowale ko mākou kino i nā minelala a me nā wikamina koʻikoʻi, ʻoiai ka calcium a me ka wikamina D , ma kēia ʻano. I nā kamaliʻi ʻōpio, hiki i kēia ke hoʻopilikia i ka ulu ʻana. Hiki nō hoʻi ke loaʻa ka nalowale o ka lauoho, nā kui nāwaliwali, a me nā maʻi hoʻonāwaliwali i ka iwi e like me ka "(Osteoporosis)" (maʻi lahilahi o ka iwi).

He aha nā pilikia maʻamau o ka nephrotic syndrome?

Inā ʻaʻole mālama ʻia, hiki mai nā pilikia e like me:

• `(ʻEha puʻupaʻa koʻikoʻi)` - He kūlana kahi e pau koke ai ka hana pono ʻana o nā puʻupaʻa.
• Anemia - Ka nele o nā hunaola koko olakino e lawe ana i ka oxygen i nā ʻōkana o ke kino.
• ʻO ka maʻi ʻaʻa coronary - Nā waihona momona i loko o nā aʻa e hoʻolako koko i ka puʻuwai.
• Hypertension - Ke koko kiʻekiʻe aʻe ma mua o ka maʻamau i kona hele ʻana ma o nā kīʻaha koko.
• Hypothyroidism - ʻAʻole hoʻokuʻu ka ʻōpū thyroid i ka nui o ka hormone thyroid i loko o ke koko.

He aha nā kumu o ka maʻi nephrotic?

ʻO ka hapa pinepine, ua hōʻino ʻia kēia mau `(glomeruli)` ma muli o nā maʻi puʻupaʻa. ʻAʻole maopopo i nā kauka a me nā mea noiʻi ke kumu e hoʻopilikia pololei ai kēia mau maʻi i ka `(glomeruli)`. ʻO kēia mau `(glomeruli)` i hōʻino ʻia ke kumu nui o ka nephrotic syndrome. ʻO kekahi o kēia mau maʻi:

• `(Amyloidosis)` : Ma kēia, ua waiho ʻia kekahi ʻano protein i kapa ʻia ʻo amyloid i loko o ko kākou mau kino koʻikoʻi. Hana pinepine kēia i loko o nā puʻupaʻa. A laila e emi ana ka hiki ke kānana o nā puʻupaʻa.
• `(ʻO ka nephropathy pili i ka maʻi diabetes)`Nephropathy: ʻO kēia ka wā e hana pono ʻole ai nā puʻupaʻa. Hiki mai kēia ʻano ke hōʻino ka maʻi diabetes i kekahi a ʻoi aku paha o nā aʻalolo i loko o nā puʻupaʻa. Hiki i kēia ke hana i ka mae ʻana o ka ʻiʻo, ka nāwaliwali o nā ʻiʻo, a me ka ʻeha.
• ʻO ka glomerulosclerosis segmental Focal (FSGS) : Hoʻoulu kēia i ka ʻeha ma nā ʻāpana liʻiliʻi o ka glomeruli. Hiki i kēia ke alakaʻi i ka pehu ʻana, ka hāʻule ʻana o nā puʻupaʻa, a me ka protein i loko o ka mimi.
• Lupus : He maʻi autoimmune ʻo Lupus. Hoʻoulu ia i ka mumū, ka pehu, a me ka ʻeha ma ke kino holoʻokoʻa. Hiki iā ia ke hoʻopilikia i nā puʻupaʻa.
• ʻO ka nephropathy membranous : I kēia, hoʻouka ka ʻōnaehana pale ponoʻī o ko mākou kino i nā membrane kānana i loko o nā puʻupaʻa.
• ʻO ka maʻi loli liʻiliʻi (MCD) : He ʻano nephropathy kēia kahi i hana pono ʻole ai nā puʻupaʻa. Eia nō naʻe, ʻaʻole hōʻike kahi biopsy puʻupaʻa i kekahi pōʻino koʻikoʻi i ka glomeruli a i ʻole ka ʻiʻo puʻupaʻa. ʻOiai hiki ke hana i kēlā me kēia makahiki, ʻoi aku ka maʻamau i nā keiki ʻōpio.

Pehea e ʻike ʻia ai ka maʻi nephrotic?

Hana nā kauka i kekahi mau hoʻokolohua e ʻike ai i kēia maʻi:

Nā hoʻokolohua urinalysis

ʻIke ʻia kēia e kahi urinalysis, kahi e nānā ai i ke ʻano, ka haku mele kemika, a me ke ʻano microscopic o kāu mimi.

• Hoʻāʻo dipstick : Ma kēia hoʻāʻo, mimi ʻoe i loko o kahi pahu kūikawā ma ke keʻena o ke kauka a i ʻole ka haukapila. A laila, kau ke kauka a kahu maʻi paha i kahi ʻāpana pepa i uhi ʻia i ka kemika (dipstick) i loko o ka pahu. Inā he albumin i loko o kou mimi, e loli ke kala o ka ʻāpana.
• Nā hoʻāʻo protein mimi : Hana ʻia kēia mau hoʻāʻo inā pono kahi ana pololei.
• He hāpana mimi hoʻokahi : Hoʻouna ʻia kēia i kahi keʻena hoʻokolohua. E nānā lākou i ka nui o ka `(albumin)` a me ka `(creatinine)` i loko o kāu mimi (`(albumin-to-creatinine ratio)`). Inā ʻoi aku ma mua o 30 milligrams o `(albumin)` no ka gram o `(creatinine)`, he pilikia paha ia.
• ʻOhi mimi 24 hola : E hāʻawi ke kauka iā ʻoe i kahi ʻōmole e hōʻiliʻili i kāu mimi ma ka home. I ka lā o ka hoʻāʻo:
• ʻO ka mea mua i ke kakahiaka, ke ala ʻoe, e mimi i loko o ka lua e like me ka mea maʻamau.
• A laila mimi i loko o kēlā ʻōmole i ka lā a pau a hiki i kou hiamoe ʻana i ka pō.
• I ke kakahiaka aʻe, i kou ala ʻana, e mimi i loko o ka ʻōmole hoʻokahi no ka manawa hope loa.
• A laila pono ʻoe e lawe i kēlā hāpana i ke keʻena o ke kauka a i ʻole i ka lab, kahi e ana wale ai lākou i ka nui o ka `(albumin)`.

Nā hoʻāʻo koko

Ma kēia, hoʻohana ke kauka i kahi nila lahilahi e lawe i kahi koko liʻiliʻi mai kahi aʻa koko ma kou lima. Hoʻouna ʻia ia i kahi keʻena hoʻokolohua no ka hoʻāʻo ʻana. Inā he haʻahaʻa ka pae o ka `(albumin)` a i ʻole nā ​​​​protein ʻē aʻe i loko o ke koko, he nephrotic syndrome paha ia. Nānā pū lākou i nā pae o ka cholesterol a me ka `(triglyceride)` i loko o ke koko. Ke haʻahaʻa ka `(albumin)`, hiki i kēia mau mea ke piʻi.

ʻO ka biopsy puʻupaʻa

Ma kēia kaʻina hana, lawe ke kauka i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kou puʻupaʻa a nānā iā ia ma lalo o kahi microscope. Hoʻomaʻamaʻa ʻia ka ʻāpana ma mua o ke kaʻina hana, no laila ʻaʻole ʻoe e ʻeha. Hiki ke hāʻawi ʻia iā ʻoe kahi lāʻau hiamoe liʻiliʻi e kōkua iā ʻoe e hoʻomaha. A laila hoʻokomo ke kauka i kahi nila ma o kou ʻili i loko o kou puʻupaʻa e lawe i ka hāpana ʻiʻo.

Eia nō naʻe, inā loaʻa iā ʻoe ka maʻi diabetes a kānalua kāu kauka i ka nephrotic syndrome, ʻaʻole pono pinepine kahi biopsy kidney. Hiki i kāu mōʻaukala olakino, nā hoʻāʻo mimi, a me nā hoʻāʻo koko ke kōkua i ka ʻike ʻana i ka nephrotic syndrome i hoʻokumu ʻia e ka maʻi diabetes.

Hiki ke ho'ōla ʻia ka nephrotic syndrome?

ʻAʻole kēia he maʻi hiki ke ho'ōla loa ʻia . Akā, aia ka nūhou maikaʻi! Inā loaʻa ia i nā keiki ʻōpio, nalo pinepine ia i ka wā ʻōpiopio, ma kahi o 18-20 mau makahiki.

Hiki i ka lāʻau lapaʻau ke kāohi i nā hōʻailona a hoʻōki i ka hōʻino hou ʻana i nā puʻupaʻa.

ʻO ka mālama ʻana e pili ana i ka mālama ʻana i ke kumu kumu, ka hoʻēmi ʻana i ke koko kiʻekiʻe, ka cholesterol, ka pehu ʻana, a me ka pilikia o ka maʻi. ʻO ka hapa nui, pili ia i ka lāʻau lapaʻau a me nā hoʻololi ʻana i ka meaʻai .

• Hiki i kekahi mau lāʻau lapaʻau koko kiʻekiʻe ke kōkua i ka kaohi ʻana i ka maʻi puʻupaʻa e hoʻoulu ai i ka maʻi nephrotic. Eia kekahi laʻana:
• `(Nā mea hoʻopaʻa i ka enzyme hoʻololi-Angiotensin (ACE))`
• `(Nā mea pale i ka mea loaʻa Angiotensin (ARBs))`
• Hoʻemi kēia mau lāʻau lapaʻau i ke kaomi i loko o nā glomeruli a hoʻemi i ka nui o ka albumin i hoʻokuʻu ʻia i loko o ka mimi. Pono paha ka nui o ka poʻe i ʻelua a ʻekolu paha mau lāʻau lapaʻau e kaohi i ko lākou koko.
• Me kahi ACE inhibitor a i ʻole ARB, hiki i kāu kauka ke kuhikuhi i kahi diuretic . Kōkua nā diuretics i kou mau puʻupaʻa e wehe i ke kahe keu mai kou koko. Hiki iā lākou ke kōkua i ka hoʻēmi ʻana i ke koko a me ka pehu ʻana. ʻO nā lāʻau lapaʻau ʻē aʻe e hoʻohaʻahaʻa i ke koko e komo pū me nā beta-blockers a me nā calcium channel blockers .
• Hiki i ke kauka ke kuhikuhi i nā lāʻau "statin" e hoʻohaʻahaʻa i ka cholesterol.
• Inā loaʻa iā ʻoe ka maʻi nephrotic, he manaʻo maikaʻi nō hoʻi e loaʻa i ka lāʻau pale maʻi influenza (flu) a me ka lāʻau pale pneumococcal i kēlā me kēia makahiki. Hiki i ka lāʻau pale pneumococcal ke pale aku i nā maʻi i hoʻokumu ʻia e ka bacteria i kapa ʻia ʻo pneumococcus (e.g. nā maʻi pepeiao, pneumonia, meningitis).
• I kekahi manawa, e kuhikuhi paha kāu kauka i nā lāʻau hoʻokahe koko (anticoagulants), akā hāʻawi wale ʻia kēia mau mea inā loaʻa iā ʻoe kahi ʻūpā koko. ʻAʻole lākou e pale i ka maʻi nephrotic a i ʻole kona mau hōʻailona.

Pono anei ʻoe e makaʻala i ka meaʻai a me ka mea inu?

ʻAʻohe hopena koʻikoʻi o ka ʻai a me ka inu ʻana i ka ulu ʻana a i ʻole ka pale ʻana i ka maʻi nephrotic i nā pākeke. Akā inā loaʻa iā ʻoe kēia maʻi,Hiki ke hoʻēmi ʻia kekahi mau hōʻailona ma ka hana ʻana i nā hoʻololi i ka meaʻai.

• ʻO ka hōʻemi ʻana i ka paʻakai (sodium) i kāu meaʻai e hiki ke kōkua i ka hōʻemi ʻana i ka pehu . ʻO ka hapa nui o ka sodium i loko o ka meaʻai a mākou e ʻai ai mai ka paʻakai mai. ʻO ka inu ʻana i ka wai hou aku e hiki nō ke kōkua i ka hōʻemi ʻana i ka pehu.
• ʻO ka hōʻemi ʻana i ka momona momona a me ka cholesterol i kāu meaʻai e hiki ke kōkua i ka kaohi ʻana i ka "hyperlipidemia" (momona koko kiʻekiʻe). ʻOi aku ka maikaʻi o ka kaupalena ʻana i nā meaʻai e like me nā huahana waiū momona piha, ka ʻiʻo ʻulaʻula, ka ʻiʻo i hana ʻia, ka tīhi, nā mea palai, nā mea i hoʻomoʻa ʻia, a me nā mea ʻono.

Pehea wau e mālama ai iaʻu iho?

ʻO ke ala maikaʻi loa e mālama ai i kāu mau hōʻailona, ​​ʻo ia ka lawe ʻana i kāu mau lāʻau lapaʻau e like me ke kauoha a kāu kauka . He manaʻo maikaʻi nō hoʻi e ʻai i kahi meaʻai kiʻekiʻe i ka potassium a me ka protein, akā haʻahaʻa i ka sodium, ka momona saturated, a me ka cholesterol.

Pehea ka wikiwiki o koʻu ʻoluʻolu ma hope o ka lāʻau lapaʻau?

ʻOkoʻa kēia ma muli o ke kumu o ka nephrotic syndrome. Hiki i kekahi poʻe ke hoʻomaka e ʻoluʻolu i loko o kekahi mau lā o ka hoʻomaka ʻana o ka lāʻau lapaʻau. No kekahi poʻe, hiki ke hala i nā pule a i ʻole nā ​​mahina. He mea nui e hoʻomanawanui.

He aha ka mea e hiki mai ana i kahi kanaka me ka nephrotic syndrome?

Inā ʻike ʻia a mālama pono ʻia, loaʻa i ka poʻe me ka nephrotic syndrome nā hopena maikaʻi . Hoʻolohe maikaʻi ka hapa nui o ka poʻe i ka lāʻau lapaʻau a komo i ka remission (`(remission)`). ʻO ke ʻano kēia e nalo aku nā hōʻailona. Inā loaʻa iā ʻoe ka nephrotic syndrome i kou wā kamaliʻi, e like me ka mea i ʻōlelo ʻia ma mua, hiki nō paha ke nalo loa ia i ka wā e hiki ai ʻoe i ka wā makua.

Hiki ke pale ʻia ka maʻi nephrotic?

ʻAʻole hiki ke pale ʻia ka maʻi nephrotic, akā ʻo ka mālama pono ʻana i nā kūlana kumu (e like me ka maʻi diabetes, ke koko kiʻekiʻe) a me nā hoʻololi ʻana i ka meaʻai e hiki ke kōkua i ka hoʻomaikaʻi ʻana i nā hōʻailona a hōʻemi i ka hōʻino ʻia o nā puʻupaʻa.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi puʻupaʻa, ʻoiai ka mimi huʻa a me ka pehu, e mau ana no nā lā he nui, e ʻike koke i ke kauka . ʻO ka hiki wawe ke ʻike ʻia, ʻo ka maʻalahi ka mālama ʻana.

He aha nā nīnau āu e nīnau ai i ke kauka?

Hiki iā ʻoe ke nīnau i kēia mau nīnau ke ʻike ʻoe i ke kauka:

• "Pehea ʻoe i ʻike ai he maʻi nephrotic koʻu?"
• "Pono anei au e hana i kekahi mau hoʻokolohua hou e hōʻoia i kāu ʻike?"
• "Inā ʻaʻohe oʻu maʻi nephrotic, he aha ke ʻano ʻē aʻe e loaʻa iaʻu?"
• "He aha ke kūlana i hoʻoulu ai iaʻu i ka nephrotic syndrome?"
• "Manaʻo ʻoe e hoʻōla ʻia koʻu maʻi nephrotic me ka lāʻau lapaʻau?"
• "E nalowale anei ka maʻi nephrotic o kaʻu keiki i kona wā e ulu ana?"
• "He aha nā lāʻau lapaʻau a i ʻole nā ​​​​​​lāʻau lapaʻau āu e ʻōlelo nei?"
• "Pono anei iaʻu e hana i kekahi hoʻololi i kaʻu meaʻai?"

ʻO ka ʻokoʻa ma waena o ka Nephrotic Syndrome a me ka Nephritic Syndrome

He mau kūlana kēia ʻelua e hoʻopilikia ai i nā puʻupaʻa.

• ʻO ka hōʻailona nui o ka nephrotic syndrome ka nui o ka protein i loko o ka mimi.
• ʻO ka hōʻailona nui o ka maʻi nephritic ka mumū o nā puʻupaʻa. Hiki ke hana pinepine ʻia kēia mumū e ka maʻi, ka maʻi o nā kīʻaha koko, a i ʻole ka degeneration.

ʻO ka ʻokoʻa ma waena o ka Nephrotic Syndrome a me ka Glomerulonephritis

He maʻi puʻupaʻa nō hoʻi ka Glomerulonephritis. Ua like kona mau hōʻailona me ka nephrotic syndrome. Eia nō naʻe, ʻo ka ʻokoʻa nui ka nui o ka protein i hoʻokuʻu ʻia .

• Inā loaʻa iā ʻoe ka maʻi nephrotic, hoʻokuʻu ʻoe ma mua o 3.5 grams o ka protein i kēlā me kēia lā.
• Inā loaʻa iā ʻoe ka Glomerulonephritis, emi ma lalo o 3.5 grams o ka protein i hoʻokuʻu ʻia i kēlā me kēia lā.

He aha ka maʻi nephrotic congenital?

He kūlana kēia i loaʻa i ka wā hānau . Hiki iā ia ke alakaʻi i ka hāʻule mau loa o nā puʻupaʻa, ma waena o nā makahiki 2 a me 8. He maʻi puʻupaʻa hoʻoilina kēia. ʻO ia hoʻi, ua hoʻoili ʻia mai nā mākua a i nā keiki.

ʻO ka mea hope loa, nā mea āu e hoʻomanaʻo ai (Leka Lawe-Home)

No laila, i ka pōkole, ʻo ka nephrotic syndrome kahi kūlana kahi e hoʻokuʻu nui ai nā puʻupaʻa i ka protein i loko o ka mimi. Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka ʻōpū, ka mimi huʻa, ka pehu ʻana, ka nalowale o ka makemake, a me ka luhi pinepine e mau ana ma mua o kekahi mau lā, ʻoi aku ka maikaʻi o ka ʻimi ʻana i ke aʻo lapaʻau. E hoʻomanaʻo, hiki i ka ʻike mua a me ka mālama ʻana ke kōkua i ka mālama ʻana i kou mau puʻupaʻa i ke olakino a pale i nā pilikia koʻikoʻi . Mai hopohopo, e hahai wale i nā ʻōlelo a kāu kauka. Makemake au iā ʻoe e ho'ōla koke!

ʻO ka Nephrotic Syndrome, ka maʻi puʻupaʻa, ka protein, ka pehu ʻana, ka hoʻāʻo mimi, nā pediatrics, ka Nephrotic Syndrome