Hiki paha i kou mau puʻupaʻa ke hoʻopilikia i kou koko? E kamaʻilio kākou e pili ana i ka Renovascular Hypertension!

ʻO ke koko kiʻekiʻe, a i ʻole e like me kā mākou e ʻike nei, "kaomi," he pilikia ia e kū nei i nā poʻe he nui i kēia mau lā. Akā ua ʻike anei ʻoe i kekahi manawa hiki i kou mau puʻupaʻa ke kumu o kēia koko kiʻekiʻe? ʻAe, he ʻoiaʻiʻo. ʻO kēia ʻano koko kiʻekiʻe e kū nei i loko o nā puʻupaʻa ua kapa ʻia ʻo `(Renovascular Hypertension)` a i ʻole `(Renal Hypertension)`. E kamaʻilio kākou e pili ana i kēia me nā kikoʻī a me ka maʻalahi i kēia lā.

No ke aha e hoʻonui ai kēia i ke kaomi i loko o nā puʻupaʻa? (He aha ka Renovascular Hypertension?)

I ka ʻōlelo maʻalahi, hiki mai kēia ʻano ke ālai ʻia nā kīʻaha koko nui e hoʻolako ana i ke koko i kou mau puʻupaʻa (kapa mākou iā lākou he "Renal Arteries"). E noʻonoʻo e like me ka paipu wai e ālai ʻia ana, kahi e hōʻemi ai i ke kahe ʻana o ka wai. Ke ālai ʻia kēia mau kīʻaha koko, emi ka nui o ke koko e hiki ana i nā puʻupaʻa.

He aha ka mea e hana ʻia a laila? ʻIke nā puʻupaʻa ʻaʻole lawa ke koko. I ka pane ʻana, hoʻāla nā puʻupaʻa i kahi ʻōnaehana kūikawā o nā hormones a me nā mea ʻē aʻe. Ua kapa ʻia kēia ʻo ka `(RAAS - Renin-Angiotensin-Aldosterone System)`. Ke hoʻāla ʻia kēia ʻōnaehana `(RAAS)`, hoʻokiʻekiʻe ia i ke koko o ke kino holoʻokoʻa. Me he mea lā e hoʻouna ana nā puʻupaʻa i kahi hōʻailona e ʻōlelo ana, "ʻAʻole lawa ke koko iā mākou, e hoʻonui koke i ke koko!"

ʻO ke koko kiʻekiʻe Renovascular kahi ʻano maʻamau o ke koko kiʻekiʻe lua. ʻO ia hoʻi, ke koko kiʻekiʻe i hoʻokumu ʻia e kekahi maʻi ʻē aʻe. I kekahi manawa, hiki nō hoʻi ke kumu o ke koko kiʻekiʻe i paʻakikī ke kāohi me ka lāʻau lapaʻau (resistant hypertension). No laila, ʻo ka ʻike ʻana e pili ana kou koko i kou mau puʻupaʻa hiki ke kōkua i kāu kauka e loaʻa i ka lāʻau kūpono nou.

He aha nā hōʻailona o kēia maʻi? (Nā hōʻailona o ke koko kiʻekiʻe Renovascular)

ʻO ka hapa nui o ka manawa, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona kikoʻī i kēia kūlana `(Renal Hypertension)`. ʻO ia ka mea hopohopo iki. Eia nō naʻe, e ʻike nā kauka i kekahi mau hōʻailona mai kāu mōʻaukala olakino a me nā hoʻokolohua e kānalua ai i kēia kūlana.

Eia kekahi mau ʻōlelo aʻoaʻo:

• ʻO ka hoʻomaka koke ʻana o ke koko kiʻekiʻe ma mua o 30 mau makahiki a i ʻole ma hope o 50 mau makahiki. E noʻonoʻo e pili ana i ia mea, he mea kupanaha iki ka loaʻa koke ʻana o ke koko kiʻekiʻe ma hope o ka manawa lōʻihi me ka ʻole o nā pilikia, ma mua pono o ka makahiki e ulu mau ai ke koko, ʻeā?
• He piʻi koke ʻana o ke koko i kāohi maikaʻi ʻia ma mua. Ua lawe paha ʻoe i ka lāʻau lapaʻau koko no nā makahiki a ua kāohi maikaʻi ʻia. Akā inā pau koke ka hana a ka lāʻau lapaʻau a piʻi koke kou koko, he mea ia e hopohopo ai.
• ʻAʻole e iho ana kou koko me ka hoʻohana ʻana i kekahi mau ʻano lāʻau lapaʻau no kou koko. Inā ʻaʻole e iho ana kou koko me ka lawe ʻana i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai, aia paha kekahi kumu ʻē aʻe.
• Loaʻa nā pilikia hypertension he nui. ʻO kēia nā manawa e piʻi koke ai ke koko i kahi pae weliweli.
• Hiki ke loaʻa koke ka edema pulmonary (flash pulmonary edema). Hiki i kēia ke hoʻopilikia koke i ka hanu ʻana.
• Loaʻa ka mōʻaukala o ka hōʻiliʻili ʻana o ka plaque i loko o nā kīʻaha koko ʻē aʻe i ke kino, e like me ka puʻuwai, ka ʻāʻī, a me nā wāwae. Ua kapa ʻia hoʻi kēia he atherosclerosis.
• ʻAʻole hiki ke ʻeha ka umauma me ka ʻole o nā waihona momona nui i loko o nā aʻa coronary o ka puʻuwai.
• Ka hāʻule ʻana o nā puʻupaʻa me ke kumu ʻole i ʻike ʻia.
• ʻO ka bruit ka wā e kau ai ke kauka i kahi stethoscope i kou ʻōpū a lohe i kahi leo "swoo... swoo...". He leo ʻē kēia i hana ʻia i ka wā e kahe ai ke koko ma o kahi kīʻaha koko.

E hoʻomanaʻo, ʻo kēia nā hōʻailona a nā kauka e kānalua nei. ʻOiai he hoʻokahi a ʻelua paha o kēia mau mea iā ʻoe, ʻaʻole ia he manaʻo he Renovascular Hypertension kou. Eia nō naʻe, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​he mea naʻauao ke ʻike i ke kauka.

He aha ke kumu o kēia? (Nā kumu o ke koko kiʻekiʻe Renovascular)

ʻO ke kumu nui o kēia maʻi `(Renovascular Hypertension)` ʻo ia ka haiki ʻana o nā kīʻaha koko e lawe ana i ke koko i nā puʻupaʻa (Renal Artery Stenosis) . Aia kekahi mau kumu no kēia haiki ʻana o nā kīʻaha koko:

1. Atherosclerosis: ʻO kēia ke kumu maʻamau. E like me ka lepo a me ka popo e hōʻiliʻili ana i loko o nā paipu wai, hōʻiliʻili ka cholesterol a me nā momona ʻē aʻe i loko o nā kīʻaha koko, e hoʻohaiki ana i ke kahe koko. Hiki ke hana kēia me ka ʻelemakule, ma muli o nā ʻano ʻai maikaʻi ʻole, ka maʻi diabetes, a me ka puhi paka.

2. Fibromuscular Dysplasia (FMD): He ʻano maʻamau ʻole kēia ma mua o Atherosclerosis. Hōʻike ʻia ia e ka ulu ʻana o nā ʻiʻo a me nā ʻiʻo pili i loko o nā paia o nā kīʻaha koko, hiki ke alakaʻi i ka hāiki ʻana o nā kīʻaha koko. ʻOi aku ka maʻamau o kēia ʻano i nā wahine ʻōpio.

Ma waho aʻe o kēia mau kumu nui ʻelua, aia kekahi mau kumu ʻē aʻe i maʻamau ʻole:

• Ka mumū ʻana o nā kīʻaha koko (Vasculitis)
• ʻO ka Aneurysm o ke aʻa Renal
• Ke kaomi ʻana o ka puʻupuʻu ma ke aʻa puʻupaʻa a i ʻole ke aʻa renal
• ʻO ka fibrosis i hoʻokumu ʻia e ka radiation therapy

He aha nā pilikia e hiki mai ana ma muli o kēia? (Nā pilikia o ka Renovascular Hypertension)

ʻO kēlā me kēia ʻano koko kiʻekiʻe, me ka renovascular hypertension, hiki ke alakaʻi i nā ʻano pilikia like ʻole inā ʻaʻole mālama pono ʻia. ʻO ka mea nui loa, hiki i ke koko kiʻekiʻe lōʻihi ke hōʻino i ka puʻuwai. Ua kapa ʻia kēia he maʻi puʻuwai hypertensive .

Eia kekahi, hiki i ke koko kiʻekiʻe i mālama ʻole ʻia ke hana i nā pilikia e like me:

• Maʻi Puʻupaʻa: ʻAʻole he mea kupanaha, ʻeā? No ka mea, ua hoʻomaka ka pilikia me nā puʻupaʻa, hiki iā lākou ke hōʻino hou ʻia.
• Ka maʻi Retinal: ʻO ka hōʻino ʻana i nā kīʻaha koko palupalu i nā maka e hiki ai ke nalowale ka ʻike.
• Hahau
• Maʻi hohola

ʻO ia ke kumu he mea nui loa ke kaohi pono ʻana i kou koko.

Pehea e ʻike ai nā kauka i kēia maʻi?

ʻAʻole ʻike nā kauka i ka Renovascular Hypertension me hoʻokahi hoʻāʻo wale nō. Hiki lākou i kahi hopena ma ka hoʻohui ʻana i nā hōʻailona like ʻole, e like me ka mākaʻi. Hiki mai kēia mau hōʻailona iā lākou:

• Ma ka nānā kino ʻana iā ʻoe: No ka laʻana, nā mea e like me ke kani 'Bruit' i ʻōlelo ʻia ma luna nei āu e lohe ai me kahi stethoscope ma kou ʻōpū.
• Ma ka nānā ʻana i kāu mōʻaukala olakino: nā kikoʻī e like me nā maʻi ma mua, nā maʻi ʻohana, a me nā lāʻau lapaʻau āu e lawe ai.
• Ma ka hana ʻana i nā hoʻokolohua kūikawā.

Eia kekahi mau ʻano hoʻāʻo hiki iā ʻoe ke hana:

• Nā hoʻāʻo koko: E nānā i nā mea e like me ka hana o nā puʻupaʻa a me nā pae cholesterol.
• Nā Hoʻāʻo Mimi: E nānā inā ke hoʻokuʻu ʻia nei nā mea e like me ka protein mai nā puʻupaʻa.
• ʻO ke ultrasound puʻupaʻa a me nā hoʻokolohua radiological ʻē aʻe e hōʻike ana i ke kahe koko i loko o nā aʻa renal: Hiki i kēia ke hōʻike i ka nui a me ke ʻano o nā puʻupaʻa a inā ua ālai ʻia nā kīʻaha koko. Hiki i kahi scan kūikawā i kapa ʻia ʻo Doppler ultrasound ke ana i nā mea e like me ka wikiwiki o ke kahe koko. Pono paha ʻoe e hana i nā hoʻokolohua e like me ka CT Angiogram a i ʻole MR Angiogram.
• Nā hoʻokolohua Radiographic e hōʻike ana i ke kahe koko ma nā wahi ʻē aʻe o ke kino, no ka laʻana, nā aʻa carotid ma ka ʻāʻī: Nānā kēia i nā pilikia me nā kīʻaha koko ma nā wahi ʻē aʻe o ke kino.

Pehea e mālama ʻia ai ka maʻi hypertension Renovascular?

ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hoʻohaʻahaʻa ʻana i kou koko a me ka hoʻomaikaʻi ʻana i ke kahe o ke koko i kou mau puʻupaʻa. I ka hapa nui o ka manawa , hiki ke hoʻomalu ʻia kēia me ka lāʻau lapaʻau. Eia nō naʻe, i kekahi mau hihia, hiki ke ʻōlelo ʻia kahi hana kūikawā a i ʻole ke ʻoki kino e hoʻomaikaʻi i ke kahe o ke koko i kou mau puʻupaʻa.

Nā lāʻau lapaʻau

ʻO ka mea nui, ʻo ia ka hoʻohaʻahaʻa ʻana i ke kaomi. Ke loaʻa iā ʻoe ka `(Renal Hypertension)`, hiki i kēia mau ʻano lāʻau ʻelua ke lilo i mea maikaʻi loa:

• Nā mea hoʻopaʻa i ka Angiotensin-Converting Enzyme (ACE)
• Nā mea pale i ka mea hoʻokipa Angiotensin (ARBs)

Hana kēia mau lāʻau lapaʻau ʻelua ma ka ʻōnaehana "(RAAS)" i ʻōlelo mua ʻia. ʻO ia hoʻi, ke kāohi nei lākou i ke koko ma ka hoʻēmi ʻana i ka hana o ka ʻōnaehana hormone e hoʻonui ai i ke koko.

Me kahi ACE inhibitor a i ʻole ARB, pono paha ʻoe i nā lāʻau lapaʻau ʻē aʻe. Eia kekahi laʻana:

• Hoʻohaʻahaʻa i ka cholesterol "(Statins)"
• `(Nā Mea Pale i ke Alanui Calcium)`
• ʻO nā diuretics (i kapa ʻia hoʻi ʻo "nā pila wai")

E wehewehe pono ke kauka iā ʻoe i ka lāʻau lapaʻau āu e pono ai, i ka nui, a no ke aha. Mai hoʻōki i ka lawe ʻana i kāu lāʻau lapaʻau a hoʻololi paha i ka nui me ka ʻole o ke aʻo ʻana a ke kauka.

Nā Kaʻina Hana

I kekahi manawa, ʻōlelo nā kauka i kahi kaʻina hana i kapa ʻia ʻo Renal Artery Angioplasty (i kekahi manawa me ka stenting) e mālama i ka Renal Hypertension. Hana ʻia kēia i nā hihia aʻe:

• Inā loaʻa iā ʻoe ka `(Renal Hypertension)` ma muli o ka `(Fibromuscular Dysplasia - FMD)`.
• Inā ʻaʻole hiki iā ʻoe ke kāohi i kou koko me ka lāʻau lapaʻau wale nō.
• Inā loaʻa iā ʻoe ka hāʻule ʻana o ka puʻuwai congestive a i ʻole ka edema pulmonary no ke kumu ʻike ʻole ʻia.

ʻO ka Angioplasty e pili ana i ka hoʻopiha ʻana i kahi pōpō liʻiliʻi i loko o ke kīʻaha koko i paʻa, e hoʻonui ana i ke kīʻaha koko. I kekahi manawa, hoʻokomo ʻia kahi stent, kahi ʻōmole mesh liʻiliʻi, e pale i ka wahi i hoʻonui ʻia mai ka paʻa hou ʻana.

ʻO kahi lāʻau lapaʻau hou i ʻāpono ʻia nei, ʻo ia ka renal denervation . Hoʻohana kēia kaʻina hana i ka wela a i ʻole ka ikehu ultrasound e hōʻemi i ka hana o nā hopena nerve i loko o nā aʻa renal. Hiki paha i kēia ke kōkua i ka hoʻemi ʻana i ke koko.

Ma mua o ka hana ʻana i kekahi kaʻina hana, e wehewehe ke kauka i nā mea āpau iā ʻoe, me nā pōmaikaʻi a me nā pōʻino, ka manawa hoʻōla, a pēlā aku. I hiki iā ʻoe ke hoʻomaopopo pono i nā mea āpau a hoʻoholo.

ʻoki kino

ʻAʻole ʻōlelo pinepine ʻia ke ʻoki kino no ka Renal Hypertension. Ua kapa ʻia kēia ʻo Surgical Renal Revascularization a i ʻole Renal Bypass Surgery .

Ma kēia kaʻina hana, lawe ke kauka lapaʻau i kahi ʻāpana o kekahi kīʻaha koko ʻē aʻe i loko o kou kino, a i ʻole kahi paipu hana, a hoʻohui iā ia i kou aorta a me kou puʻupaʻa. Hoʻokumu kēia i kahi ala hou no ke kahe ʻana o ke koko i kou puʻupaʻa, e kāpae ana i ke aʻa renal i ālai ʻia. Ua like ia me ka lawe ʻana i kahi ala ʻokoʻa ke ālai ʻia kekahi alanui.

ʻOi aku ka pilikia o ke ʻoki ʻana ma mua o ka angioplasty, no laila hoʻohana wale nā ​​​​kauka iā ia i nā hihia kūikawā. Eia kekahi laʻana:

• Inā he ʻano paʻakikī ko ke aʻa renal kou, ʻo ia hoʻi ua ālai ʻia i kahi ala e paʻakikī ai ke kau ʻana i kahi stent.
• Inā ʻaʻole holomua nā hana "Minamally Invasive" i ʻōlelo mua ʻia (e like me ka angioplasty).
• Inā pono ʻoe e hana i ke ʻoki kino ma kou aorta kokoke i ke aʻa renal.

Āhea wau e ʻike ai i kaʻu mea lawelawe mālama ola?

Ke ʻike ʻia ʻoe me kēia maʻi, e haʻi aku kāu kauka iā ʻoe i ka pinepine o kou hoʻi ʻana e ʻike iā ia. He mea nui loa kēia mau manawa hoʻopaʻa no ka mea ʻo ia ka manawa e hiki ai i kāu kauka ke:

• E nānā i kou koko e ʻike ai i ka holomua o ka lāʻau lapaʻau.
• E nānā i ka hana o kou puʻupaʻa.
• E hoʻololi i kāu hoʻolālā lapaʻau inā pono.

Eia kekahi, he manawa kūpono kēia mau hālāwai nou e nīnau ai i ke kauka a kaʻana like i kou mau hopohopo.

Hiki ke ho'ōla ʻia ka Renal Hypertension?

He maʻi koko kiʻekiʻe hiki ke mālama ʻia ka hypertension Renovascular. ʻO ke ʻano kēia, hiki ke hoʻohaʻahaʻa ʻia kou koko i kahi pae olakino me nā lāʻau lapaʻau a me nā lāʻau lapaʻau ʻē aʻe. E haʻi aku kāu kauka iā ʻoe i nā mea hou aʻe e pili ana i kāu mea e manaʻo ai ma muli o kou kūlana.

ʻO ka mea nui loa, ʻo ia ka lawe ʻana i ka lāʻau lapaʻau e like me ka ʻōlelo a ke kauka, a e hahai i nā ʻōlelo kuhikuhi i hāʻawi ʻia.

Ma keʻano laulā, he mea nui loa ka mālamaʻana i kēia mau mea:

• E lawe i nā lāʻau lapaʻau a pau i kauoha ʻia e ke kauka me ka pololei a me ka manawa kūpono.
• E hahai i nā ʻōlelo aʻoaʻo a kāu kauka e pili ana i ka ʻai a me ka hoʻoikaika kino. (Hiki iā lākou ke paipai i kahi hoʻolālā ʻai kūikawā e like me ka DASH Diet. ʻO ia hoʻi ka ʻai ʻana i kahi ʻai haʻahaʻa i ka paʻakai a kiʻekiʻe i nā huaʻai a me nā mea kanu.)
• E kamaʻilio me kāu kauka e pili ana i ka nui o ka hana kino e kūpono iā ʻoe.

Ke ʻike ʻia ʻoe me ka Renovascular Hypertension, hiki paha iā ʻoe ke wehewehe i kekahi o nā "hōʻailona" āu i ʻike ai i kēia mau lā. Malia paha ua piʻi koke kou koko ma hope o ka maʻamau no nā makahiki. A i ʻole ʻaʻole paha e hana hou ana kāu lāʻau lapaʻau koko maʻamau.

ʻOiai kou kūlana, ʻo ka ʻike ʻana i ke ʻano o kou mau puʻupaʻa e pili ana i kou koko koko e hiki ke kōkua i kāu kauka e hoʻolālā i ka lāʻau kūpono nou. Inā he mau nīnau kāu e pili ana i kāu lāʻau lapaʻau a pehea e mālama ai i kou kūlana, e ʻoluʻolu e nīnau i kāu kauka.

Leka Lawe-Home (Nā Mea Koʻikoʻi e Hoʻomanaʻo)

ʻAe, e hōʻuluʻulu kākou i kekahi o nā mea e pono ai ʻoe e hoʻomanaʻo mai nā mea a mākou i kamaʻilio ai:

• ʻO ke koko kiʻekiʻe ʻo Renovascular hypertension kahi maʻi i hoʻokumu ʻia e ka ālai ʻana o nā aʻa koko e lawe ana i ke koko i nā puʻupaʻa.
• ʻAʻohe paha he mau hōʻailona kikoʻī o kēia, akā manaʻo nā kauka he ma muli o kekahi mau hōʻailona.
• ʻO nā kumu nui, ʻo ia nā waihona momona i loko o nā kīʻaha koko (Atherosclerosis) a me Fibromuscular Dysplasia (FMD).
• Hiki ke hoʻomalu pinepine ʻia kēia me ka lāʻau lapaʻau. I kekahi manawa, pono paha nā kaʻina hana e like me ka "Angioplasty".
• He mea nui loa e hahai pololei i nā ʻōlelo a ke kauka a e ʻike i ke kauka i ka manawa kūpono.
• He kūlana hiki ke kāohi ʻia kēia. No laila, he mea nui e pale aku i ka hopohopo a e ʻimi i ka lāʻau kūpono.

Inā manaʻo ʻoe he pilikia like kou, mai kānalua e ʻike i ke kauka a loaʻa ka ʻōlelo aʻoaʻo. E noho olakino!

`Ke koko kiʻekiʻe o ka puʻupaʻa, ke koko kiʻekiʻe o ka puʻupaʻa, ka stenosis o ke aʻa o ka puʻupaʻa, ke kaomi, ke koko kiʻekiʻe, ka maʻi puʻupaʻa