E kamaʻilio kākou e pili ana i ka stenosis o ke aʻa renal?

Loaʻa iā ʻoe ke koko kiʻekiʻe (hypertension)? Manaʻo ʻoe he paʻakikī iā ʻoe ke kāohi iā ia ma hope o ka lawe ʻana i kekahi mau lāʻau lapaʻau? A i ʻole ua haʻi aku ke kauka iā ʻoe ʻaʻole hana pono kou mau puʻupaʻa no ke kumu ʻike ʻole ʻia? I kekahi manawa ʻo ke kumu o kēia mau pilikia he kūlana a mākou e kamaʻilio nui ʻole ai, akā he mea nui loa ia. I kēia lā e kamaʻilio mākou e pili ana i ia mea. ʻO ia ka haiki ʻana o nā kīʻaha koko e alakaʻi ana i nā puʻupaʻa, i ka lāʻau lapaʻau ua kapa mākou i kēia ʻo Renal Artery Stenosis.

I ka ʻōlelo maʻalahi, he aha ka Renal Artery Stenosis?

ʻAe, e hoʻomaopopo kākou i kēia ma kēia ʻano. Ua like nā puʻupaʻa ʻelua i loko o ko kākou kino me nā kānana ʻelua. ʻO ka hana nui o nā puʻupaʻa, ʻo ia ke kānana i nā huahana ʻōpala i loko o ke kino mai ke koko a hoʻokuʻu iā lākou ma ke ʻano he mimi. No ka hana pono ʻana i kēia hana, pono nā puʻupaʻa e loaʻa i kahi lako koko maikaʻi. Aia ʻelua mau kīʻaha koko nui e lawe ana i ke koko mai ko kākou puʻuwai i nā puʻupaʻa. Kāhea mākou i kēia mau mea he 'Renal Arteries'.

ʻO ka Renal Artery Stenosis kahi kūlana kahi e haiki ai kekahi a i ʻole nā ​​​​​​aʻa ʻelua e lawe ana i ke koko i nā puʻupaʻa mai loko mai. Ua like ia me kahi paipu wai e paʻa ana i ka lepo. Ke paʻa nā aʻa e like me kēia, ʻaʻole loaʻa i nā puʻupaʻa ke koko e pono ai lākou. Hiki i kēia ke hana i ʻelua mau pilikia nui:

1. Ke Koko Kiʻekiʻe: Ke emi ke kahe o ke koko i nā puʻupaʻa, manaʻo nā puʻupaʻa ua emi ke koko i loko o ke kino holoʻokoʻa. No laila, hoʻokuʻu lākou i nā hormones e hoʻāʻo e hoʻonui i ke koko i loko o ke kino. ʻO ka hopena, he koko kiʻekiʻe paʻakikī ke kāohi.

2. Ka hōʻino ʻana o nā puʻupaʻa: Ke hāʻawi ʻole ke koko i nā meaʻai a me ka oxygen e pono ai no ka manawa lōʻihi, hoʻomaka ka hōʻino ʻia ʻana o nā hunaola i loko o nā puʻupaʻa. Inā hoʻomau kēia, hiki iā ia ke holomua i ka maʻi puʻupaʻa mau loa a hiki i ka hāʻule ʻana o nā puʻupaʻa.

ʻO wai ka mea i pilikia nui i ka loaʻa ʻana o kēia maʻi?

ʻO ke kumu nui o kēia, he maʻi i kapa ʻia ʻo Atherosclerosis . E noʻonoʻo e pili ana i ka paipu wai i loko o kā mākou poho holoi kīhini. I ka hala ʻana o ka manawa, paʻa nā mea e like me ka ʻaila a me ka lepo i loko a paʻa i loko o ka paipu, ʻeā? Hana like ka mea i loko o ko mākou mau kīʻaha koko. ʻO nā mea i makemake ʻole ʻia e like me ka ʻaila a me ka cholesterol i loko o ka meaʻai a mākou e ʻai ai, paʻa lākou ma nā paia o nā kīʻaha koko e like me ka ʻōpala. Kāhea mākou i kēia 'plaque'. I ka hala ʻana o ka manawa, hōʻiliʻili kēia plaque a hoʻemi i ka hakahaka i loko o nā aʻa koko. Ke hana ʻia kēia i loko o nā aʻa koko e lawe ana i ke koko i nā puʻupaʻa, loaʻa ka Renal Artery Stenosis.

No laila, ʻo nā mea āpau e kōkua ai i ka atherosclerosis e hoʻonui pū i ka pilikia o ka stenosis o ke aʻa renal. E nānā kākou i kēlā mau mea.

Ma waho aʻe o ka atherosclerosis, hiki ke hana ʻia kēia maʻi e kahi maʻi laha ʻole i kapa ʻia ʻo Fibromuscular Dysplasia . ʻO kēia ka wā e ulu ai nā pūnaewele i loko o nā paia o nā kīʻaha koko me ke ʻano ʻē, e hoʻohaiki ana i nā kīʻaha koko. ʻOi aku ka maʻamau o kēia maʻi i nā wahine.

He aha nā hōʻailona? Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe?

Eia ka pilikia nui. ʻAʻole hōʻike ka Renal Artery Stenosis i kekahi mau hōʻailona a hiki i ka wā e koʻikoʻi loa ai. I ka wā e haiki loa ai nā kīʻaha koko, e hoʻomaka ai nā pilikia e kū mai. ʻO nā pilikia a mākou i kamaʻilio ai ma mua, ʻo ia ke koko kiʻekiʻe a me ka hāʻule ʻana o nā puʻupaʻa.

I ka emi ʻana o ka hana o kou mau puʻupaʻa, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka pehu ʻana ma nā ʻāpana o ke kino: ʻoiai nā wāwae, nā kuʻekuʻe wāwae, a i kekahi manawa ke alo (edema).
• Luhi a me ka hiamoe: Hiki iā ʻoe ke luhi i nā manawa a pau ma muli o ka hōʻiliʻili ʻana o nā huahana ʻōpala i loko o ke kino.
• Paʻakikī ka hanu ʻana: Hiki ke hana ʻia kēia ʻano ma muli o ka hōʻiliʻili ʻana o ka wai i loko o nā māmā.
• Ka nalowale o ka makemake e ʻai, ka nausea, a me ka luaʻi ʻana.
• Ka paʻakikī i ka noʻonoʻo ʻana, ka manaʻolana ʻole.
• ʻO ka mimi pinepine a pinepine ʻole paha.
• Nā loli o ka ʻili: ʻIli maloʻo, maneʻo, a i ʻole ka ʻeleʻele ʻana o ka ʻili.
• Ka wiwi ʻana me ke kumu ʻole.
• ʻEha pinepine ka ʻeha.
• ʻŌpū ʻiʻo.

Pehea e ʻike ai ke kauka i kēia maʻi?

Ke hele ʻoe e ʻike i kāu kauka, hiki iā ia ke kānalua i kēia ma muli o kāu mau hōʻailona a me nā kumu pilikia. A laila, hiki iā lākou ke hana i kekahi mau hoʻokolohua e hōʻoia i ke kūlana.

1. Hoʻokolokolo kino: E ana ke kauka i kou koko. E kau ʻia ka stethoscope i loko o kou ʻōpū, ma luna pono o kou mau puʻupaʻa, a e hoʻolohe lākou i kahi kani 'whoosh' kūikawā, ʻo ia ke kani o ke koko e holo ana ma o kahi aʻa koko i haiki.

2. Nā Hoʻāʻo Hana o nā Puʻupaʻa: Hoʻāʻo ʻia nā hāpana koko a me ka mimi no kēia. Ke nānā nei lākou i nā pae kiʻekiʻe o nā huahana ʻōpala e like me ka creatinine a me ka urea i loko o ke koko, a no ka protein i loko o ka mimi. Hiki i kēia ke hāʻawi i kahi manaʻo inā ua hōʻino ʻia nā puʻupaʻa.

3. Nā Kiʻi Kiʻi: ʻO kēia ke ala maikaʻi loa e hoʻoholo pololei ai inā ua ālai ʻia nā aa koko.

• ʻO Duplex Ultrasound: Hoʻohana kēia i nā nalu kani e lawe i nā kiʻi o nā aʻa koko e lawe ana i ke koko i nā puʻupaʻa, e nānā ana i ke kahe ʻana o ke koko a inā ua ālai ʻia nā aʻa koko.
• CT angiography (CTA): Hana ʻia kahi scan CT ma ke komo ʻana i kahi kala hoʻohālikelike kūikawā i loko o ke kino. Hoʻopuka kēia i nā kiʻi 3D o nā kīʻaha koko a hiki ke ʻike maopopo i nā wahi i ālai ʻia.
• MR Angiography (MRA): Ua like kēia me CTA, akā hoʻohana ia i kahi kahua magnetic.

He aha nā lāʻau lapaʻau no kēia?

Aia ka lāʻau lapaʻau i ke ʻano o ka paʻa ʻana o kou mau kīʻaha koko, ke ʻano o kou mau hōʻailona, ​​a me ka nui o ka pōʻino i hana ʻia i kou mau puʻupaʻa. ʻEkolu mau ʻano nui o ka lāʻau lapaʻau.

1. Nā loli o ke ʻano o ka nohona

ʻO kēia ke kumu, no ka mea he mea nui ia e kāohi i ke kumu nui, ʻo ia hoʻi ka atherosclerosis.

• ʻAi olakino: E kālele i nā meaʻai haʻahaʻa i ka paʻakai, ke kō, ka ʻaila, a me ka cholesterol. E hoʻokomo i nā huaʻai, nā mea kanu, nā legumes, a me nā palaoa piha i kāu papaʻai.
• Hoʻoikaika kino mau: He mea nui loa ke komo ʻana i ka hoʻoikaika kino maʻalahi, e like me ka hele wāwae no ka liʻiliʻi he 30 mau minuke i ka lā.
• Kaohi kaumaha: Inā kaumaha ʻoe, hiki i ka lilo ʻana o ke kaumaha ke kōkua i ka kaohi ʻana i ke koko, ka cholesterol, a me ka maʻi diabetes.
• Ka haʻalele loa ʻana i ka puhipaka: He mea kēia e pono ai ʻoe e hana.

2. Nā lāʻau lapaʻau (nā ʻano lāʻau lapaʻau)

Me nā loli o ke ʻano o ka nohona, hiki i kāu kauka ke kuhikuhi i kekahi mau lāʻau lapaʻau nāu.

• Nā lāʻau lapaʻau koko: ʻO nā ACE inhibitors a me nā ARB nā lāʻau lapaʻau i hoʻohana nui ʻia. Ke ālai nei kēia mau mea i nā hormones e hoʻohaiki ana i nā kīʻaha koko. Hiki ke hoʻohana ʻia nā lāʻau lapaʻau ʻē aʻe e like me nā beta-blockers a me nā calcium channel blockers.
• Nā lāʻau hoʻohaʻahaʻa kolesterol: ʻO kahi papa o nā lāʻau i kapa ʻia ʻo statins e hōʻemi i ka pae o ka cholesterol ʻino i loko o ke koko a kaohi i ka hōʻiliʻili ʻana o ka plaque.
• Nā Anticoagulants: ʻO nā lāʻau lapaʻau e like me ka aspirin e hoʻomāmā i ke koko a hoʻomaʻalahi i ke kahe ʻana o ke koko ma o nā aʻa koko i ʻōniʻoniʻo ʻia.
• Diuretics: Kōkua kēia i ka hoʻohaʻahaʻa ʻana i ke koko ma ka hoʻopau ʻana i ka wai keu a me ka paʻakai mai ke kino ma o ka mimi.

3. ʻO ke ʻoki kino a i ʻole nā ​​​​kaʻina hana ʻē aʻe

Inā koʻikoʻi ka paʻa ʻana o nā aʻa koko ʻaʻole hiki ke kāohi ʻia me nā lāʻau lapaʻau a me nā loli o ke ʻano o ka nohona, a inā e emi koke ana ka hana o nā puʻupaʻa, hiki i kāu kauka ke ʻōlelo i ke ʻoki ʻana.

• ʻO Angioplasty a me Stenting: ʻO kēia ka lāʻau lapaʻau maʻamau. Ma kēia kaʻina hana, ua hoʻokomo ʻia kahi paipu lahilahi loa (catheter) ma o kahi aʻa koko ma ka wāwae a i ʻole ka lima i ke aʻa koko renal i paʻa. Hoʻopiha ʻia kahi pōpō liʻiliʻi ma ka hopena o ka paipu e hoʻonui i ka wahi i paʻa. A laila, ua kau ʻia kahi paipu liʻiliʻi e like me ka mesh (stent) i loko o ke aʻa koko e pale aku ai i ka pani hou ʻana.
• ʻO Renal Artery Bypass: E like me ka bypass puʻuwai, pili kēia kaʻina hana i ka hana ʻana i kahi ala hou no ke koko e kāpae i ke aʻa i paʻa. Pili kēia i ka hoʻohana ʻana i kahi ʻāpana o ke kīʻaha koko i lawe ʻia mai kahi ʻāpana ʻē aʻe o ke kino a i ʻole kahi paipu hana.
• Renal Endarterectomy: He hana ʻoki kēia e wehe ai i ke kīʻaha koko a wehe i ka palaki i kūkulu ʻia i loko.

Āhea ʻoe e ʻike koke ai i ke kauka?

Inā ʻike ʻoe he Renal Artery Stenosis kou, a inā he maʻi puʻupaʻa kou, a ʻike ʻoe i kekahi o kēia mau hōʻailona , ​​e ʻike koke i ke kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

Hiki i kēia kūlana ke lilo i mea ʻino aʻe i ka hala ʻana o ka manawa. No laila, he mea nui loa ia e ʻike mua iā ia a hahai pono i nā ʻōlelo a kāu kauka. Inā ʻoe e hana pēlā, hiki iā ʻoe ke hoʻēmi i ka hōʻino ʻia o kou mau puʻupaʻa a ola i kahi ola maʻamau.