He mea weliweli anei kēia i kou mau puʻupaʻa? (Renal Papillary Necrosis) E aʻo kākou e pili ana i ia mea!

Ua ʻike anei ʻoe i ka nui o ka hana a nā puʻupaʻa liʻiliʻi ʻelua i loko o ko kākou kino? ʻO ka ʻoiaʻiʻo, ʻo nā puʻupaʻa nā ʻōkana nui e kānana i nā huahana ʻōpala a hoʻomaʻemaʻe i ke koko i loko o ko kākou kino. Eia nō naʻe, i kekahi manawa hiki i kēia mau puʻupaʻa ke loaʻa nā maʻi a kākou e manaʻo ʻole ai. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi koʻikoʻi iki, akā inā ʻike ʻoe iā ia, hiki iā ia ke kōkua iā ʻoe e kaohi a pale aku iā ia.

Pehea e hana ai nā puʻupaʻa? He aha ka Renal Papillary Necrosis?

I ka ʻōlelo maʻalahi, ua like ko kākou mau puʻupaʻa me ʻelua mau kānana nui i loko o ko kākou kino. ʻO kā lākou hana nui, ʻo ia ke kānana i nā huahana ʻōpala i makemake ʻole ʻia i loko o ke koko a hoʻokuʻu iā lākou ma ke ʻano he mimi. No ka hana ʻana i kēia, komo ke koko i loko o nā puʻupaʻa a hele ma waena o nā kahawai liʻiliʻi he nui. Hōʻiliʻili ʻia kēia mau huahana ʻōpala mai ka ʻaoʻao waho o ka puʻupaʻa a laila hele mai i waenakonu o ka puʻupaʻa, ʻo ia ka medulla puʻupaʻa . Eia nā ʻāpana i ʻano funnel. ʻO ka piko o kēia mau funnel, i kapa ʻia ʻo ka renal papilla, e hōʻiliʻili i ka mimi. Mai laila mai, hele ka mimi ma o nā ureters i ka ʻōpū mimi a puka i waho. Pēlā ka hana a ko kākou mau puʻupaʻa.

ʻO ka renal papillary necrosis a mākou e kamaʻilio nei i kēia manawa, ʻo ia ka make ʻana o nā cell a me nā ʻiʻo ma ka ʻaoʻao waena o ka puʻupaʻa (`Medulla`) a me ka renal papilla (`Renal Papilla`) aʻu i ʻōlelo ai ma mua. E noʻonoʻo wale, ke hana pono ʻole kēlā mau wahi, ʻaʻole hana pono ka hana a nā puʻupaʻa, ʻeā? Ma muli o kēia, nāwaliwali mālie nā puʻupaʻa, a hiki i ka hopena ke alakaʻi i ka hāʻule ʻana o ka puʻupaʻa .

ʻO wai ka mea i pilikia nui no kēia maʻi?

ʻO kēia maʻi (Renal Papillary Necrosis) ka mea maʻamau i ka poʻe ma luna o 60 mau makahiki. Kuhikuhi pū nā kauka he ʻoi aku ka nui o ka loaʻa ʻana o nā wahine ma mua o nā kāne.

He aha nā kumu o ka Renal Papillary Necrosis?

Aia kekahi mau kumu nui e kōkua ai i ka hanana ʻana o kēia maʻi. E nānā kākou i ke ʻano o lākou.

• ʻO ka maʻi diabetes mellitus : ʻO kēia ke kumu nui loa a maʻamau. ʻO ka poʻe me ka maʻi diabetes i kāohi pono ʻole ʻia e loaʻa i ka pilikia nui o ka hōʻino ʻia ʻana o nā puʻupaʻa. ʻO ke kiʻekiʻe o ke kō koko i loko o kahi manawa lōʻihi e hōʻino i nā kīʻaha koko palupalu i loko o nā puʻupaʻa.
• Ka hoʻohana nui ʻana i nā lāʻau ʻeha (NSAID) : Inā ʻoe e hoʻohana mau i nā lāʻau ʻeha (nā lāʻau anti-inflammatory non-steroidal, a i ʻole NSAID) e like me ka aspirin, ibuprofen, a i ʻole naproxen no ka manawa lōʻihi me ka ʻole o ke kūkākūkā ʻana me ke kauka, pono ʻoe e makaʻala loa. ʻO ka lawe ʻana i ka nui o kēia mau mea hiki ke hoʻopilikia i nā kīʻaha koko i loko o nā puʻupaʻa a hōʻino i nā papillae renal.
• Maʻi ʻeha o ke kelepona ʻokiʻokiHe maʻi hoʻoilina kēia. I loko o kēia maʻi, loli ke ʻano o nā hunaola koko ʻulaʻula a hiki iā lākou ke paʻa i loko o nā kīʻaha koko. Hiki i kēia ke alakaʻi i ka nele o ke koko i nā puʻupaʻa (Renal Papillary Necrosis).

Ma waho aʻe o kēia mau kumu nui, hiki i kekahi mau kūlana ʻē aʻe ke hana i ka Renal Papillary Necrosis:

• Maʻi akepaʻa mau loa
• ʻO Pyelonephritis, kahi maʻi bacteria o nā puʻupaʻa (hiki ke hōʻino i ka papillae renal)
• ʻO Renal Tuberculosis, kahi maʻi e hoʻopilikia ai i nā puʻupaʻa ma waho o nā māmā
• ʻO ka Renal Vein Thrombosis (ʻaʻa koko i loko o ke aʻa e lawe ana i ke koko mai nā puʻupaʻa)
• Ka pale ʻana o ka Ureter (no ka laʻana, ma muli o nā pōhaku mimi)
• ʻO Vasculitis, kahi mumū o nā kīʻaha koko

ʻO ka mea nui, ʻaʻole e loaʻa i nā kānaka a pau i loaʻa i hoʻokahi a ʻoi aku paha o kēia mau kumu (Renal Papillary Necrosis). Akā, ʻoi aku ke kiʻekiʻe o ka pilikia.

Ke hoʻopilikia nei kēia i nā puʻupaʻa ʻelua?

ʻAe, ua hōʻike ʻia ma kahi o ʻehiku o ka ʻumi mau kānaka , hoʻopilikia kēia ʻano (Renal Papillary Necrosis) i nā puʻupaʻa ʻelua .

He aha nā hōʻailona o ka (Renal Papillary Necrosis)?

I nā pae mua o kēia maʻi, ʻaʻohe paha he mau hōʻailona . ʻO ia ke kumu he paʻakikī ke ʻike a mālama iā ia i ka wā mua. E noʻonoʻo, ʻaʻohe ou pilikia, akā ua hōʻino ʻia paha kou mau puʻupaʻa mai loko mai. Eia nō naʻe, hiki nō hoʻi ke ʻike hewa ʻia kēia i ka wā e hoʻāʻo ai no kekahi maʻi ʻē aʻe.

Eia nō naʻe, i ka wā e ʻoi aku ka koʻikoʻi o ke kūlana (Renal Papillary Necrosis), hiki ke ʻike ʻia nā hōʻailona e like me kēia:

• ʻEha ka mimi ʻana (Dysuria)
• ʻO ke kuni a me nā ʻūlū (ʻoi aku hoʻi inā hele pū me kahi maʻi)
• Koko i loko o ka mimi (`Hematuria`) - Hiki ke ʻike ʻia ka nui o ke koko i ka maka ʻōlohelohe (hiki i ka mimi ke ʻulaʻula a ʻeleʻele paha), a i ʻole he liʻiliʻi loa ia a hiki ke ʻike wale ʻia ma lalo o kahi microscope.
• ʻO ka makemake pinepine e mimi i ka pō ('Nocturia')
• ʻO ka piʻi ʻana ma ke ʻano ʻē o ka nui o nā hunaola koko keʻokeʻo i loko o ka mimi (`Pyuria`) - ʻo ia hoʻi, e like paha ka mimi me ka pus, a e ʻike ʻia paha ka mimi he ao.
• ʻEha nui ma nā ʻaoʻao ʻelua o ke kua, ma waena o nā iwi ʻaoʻao a me nā iwi ʻūhā (kahi o nā puʻupaʻa). Hiki ke hiki koke mai kēia ʻeha a i ʻole e hoʻonui mālie ʻia.
• Nā maʻi pinepine o ke ala mimi.

Pehea e ʻike ʻia ai ka Renal Papillary Necrosis?

E hana nā kauka i kekahi mau hoʻokolohua e ʻike ai i kēia maʻi (Renal Papillary Necrosis). Ma hope o ka hoʻolohe ʻana i kāu mau hōʻailona a me ka mōʻaukala olakino, hiki iā lākou ke kauoha i nā hoʻokolohua e like me:

• ʻUrographyʻO kēia ka lawe ʻana i kahi X-ray, CT scan, a i ʻole MRI o kou mau puʻupaʻa. Ma mua o ka hoʻāʻo ʻana, e hāʻawi ʻia ʻoe i kahi kala kūikawā (he kala) ma o kahi aa. Kōkua kēia i ka ʻike maopopo ʻana i nā wahi i hōʻino ʻia i nā puʻupaʻa a me nā loli i loko o nā papillae.
• Ureteroscopy : Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi a palupalu (me kahi kāmela ma ka hopena) ma o ka urethra e nānā pololei i loko o ka ʻōpū mimi, nā ureters, a me nā puʻupaʻa. ʻAe kēia i ke ʻano o nā papillae e ʻike maopopo ʻia.
• Biopsy Kidney : Ma kēia hoʻāʻo, lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupaʻa me ka hoʻohana ʻana i kahi nila kūikawā a nānā ʻia ma lalo o kahi microscope. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā ua make nā cell a ua hōʻino ʻia paha ka ʻiʻo.

Nā hoʻāʻo koko a me ka mimi

Eia kekahi, he mea nui loa nā hoʻāʻo koko a me ka mimi e nānā i ka hana o nā puʻupaʻa:

• Hoʻāʻo ʻia ka naikokene urea koko (BUN) : Ke ana kēia i ka nui o ka naikokene urea i loko o ke koko. He huahana ʻōpala kēia. Piʻi kēia pae i loko o ke koko ke hana pono ʻole nā ​​​​pūnaʻau.
• Hoʻāʻo Creatinine : ʻO Creatinine kekahi huahana ʻōpala i hana ʻia i ka wā o ka hana maʻamau o nā ʻiʻo. Hoʻokuʻu pinepine ʻia e nā puʻupaʻa. Inā kiʻekiʻe kona pae i loko o ke koko, hōʻike pū ia ʻaʻole hana pono nā puʻupaʻa.
• Ka Manaʻo o ka Holoʻokoʻa o ka Holoʻokoʻa (eGFR) : Ua helu ʻia kēia ma ka noʻonoʻo ʻana i nā mea e like me kou pae creatinine koko, ka makahiki, ke kāne, a me ka nui o ke kino. Hōʻike ka waiwai eGFR iā ʻoe i ka nui o ke koko e kānana ʻia e kou mau puʻupaʻa i kēlā me kēia minuke. ʻO ka haʻahaʻa o kēia waiwai, ʻo ka emi ʻana o ka hana a kou mau puʻupaʻa.
• ʻO ka Urinalysis : Pili kēia i ka lawe ʻana i kahi hāpana mimi a nānā pono iā ia (kala, moakāka), microscopically (no nā hunaola koko, nā hunaola pus, bacteria, nā ʻōpala papillary), a me ke kemika (no ka protein, ke kō). I kekahi manawa, hiki ke ʻike ʻia nā ʻāpana o ka renal papillae ma lalo o ka microscope.
• Ka lakio protein mimi/creatinine : Ke ana kēia i ka nui o ka protein i loko o ka mimi. ʻAʻole nui ka protein e hoʻokuʻu ʻia e nā puʻupaʻa olakino. ʻO ke kiʻekiʻe o ka protein i loko o ka mimi he hōʻailona ia o ka hōʻino ʻia o nā puʻupaʻa.

He aha nā pilikia e hiki mai ana o (Renal Papillary Necrosis)?

Inā ʻaʻole mālama pono ʻia kēia maʻi (Renal Papillary Necrosis), hiki i ke ʻano ke hoʻonui aʻe a alakaʻi i nā pilikia koʻikoʻi.

• Maʻi Puʻupaʻa Mau Loa (CKD) : Ma muli o ka hōʻino mau ʻana i nā puʻupaʻa, e emi mālie ana kā lākou hana, e alakaʻi ana i ka maʻi puʻupaʻa mau loa.
• Ka hāʻule ʻana o ka puʻupaʻaInā ʻoi aku ka ʻino o ke kūlana, hiki i nā puʻupaʻa ke lilo i mea hana ʻole loa, ʻo ia hoʻi hiki ke lilo i ka hāʻule ʻana o nā puʻupaʻa.
• I mea e ola ai, pono paha ʻoe i ka dialysis (ka hoʻomaʻemaʻe ʻana i kou koko me kahi mīkini) a i ʻole kahi hoʻoili puʻupaʻa .
• Ua ʻike ʻia hoʻi ua hoʻonui kēia ʻano i ka pilikia o ka hoʻomohala ʻana i kahi ʻano maʻi kanesa i kapa ʻia ʻo ka maʻi kanesa cell transitional, kahi e ulu ana i loko o ka puʻupaʻa a i ʻole ka ureter.
• Aia kekahi pilikia o ka maʻi nui (sepsis).

Pehea e mālama ʻia ai ka Renal Papillary Necrosis?

ʻAʻohe lāʻau lapaʻau kūikawā no ka Renal Papillary Necrosis. ʻO ka lāʻau lapaʻau nui , ʻo ia ka mālama ʻana i ke kumu kumu o ke kūlana . Eia kekahi laʻana:

• Inā ma muli o ka maʻi diabetes, a laila he mea nui e kaohi pono i ka maʻi diabetes.
• Inā ma muli o ka hoʻohana ʻana i ka NSAID, e hoʻōki i ka lawe ʻana i kēlā mau lāʻau.
• Inā ma muli o kahi maʻi, e hāʻawi iā ia i nā antibiotics.
• Inā he mea e ālai ana i ke ala urinary, pono e wehe ʻia.

ʻO ka pahuhopu nui ka hoʻēmi ʻana i ka hōʻino hou ʻana i nā puʻupaʻa a mālama i ka hana a nā puʻupaʻa i ka hiki.

ʻO ka holomua o ka lāʻau lapaʻau e pili ana i ka nui o ka hōʻino ʻana o nā puʻupaʻa a me ke kumu o ka maʻi. I kekahi mau hihia koʻikoʻi, hiki i ka maʻi ke hoʻomau i ka ʻino ʻoiai ua mālama ʻia. Eia nō naʻe, i nā hihia ʻaʻole koʻikoʻi loa, a inā e mālama koke ʻia ke kumu, hiki i ka hana o nā puʻupaʻa ke paʻa a hoʻomaikaʻi iki paha.

Hiki iaʻu ke pale iaʻu iho mai ka Renal Papillary Necrosis?

ʻAe, aia nā mea hiki iā mākou ke hana e pale iā mākou iho mai kēia kūlana, i kahi nui.

• ʻO ka mea nui loa, ʻo ia ka mālama ʻana i kou olakino holoʻokoʻa . He mea nui ka ʻai ʻana i ka meaʻai kaulike, ka inu ʻana i ka wai lawa, a me ka hoʻoikaika kino mau .
• Inā ʻoe e lawe ana i nā lāʻau ʻeha ʻeha ma luna o ke kūʻai aku (NSAIDs), e hoʻohana wale iā lākou e like me ke kuhikuhi ʻana ma ka pūʻolo a i ʻole e like me ke kuhikuhi ʻana a ke kauka. Mai lawe pinepine iā lākou a i ʻole no ka manawa lōʻihi ma mua o ka mea e pono ai. Mai lawe mau iā lākou no nā ʻehaʻeha liʻiliʻi a i ʻole no ke poʻo.
• Inā loaʻa iā ʻoe ka maʻi diabetes (Diabetes Mellitus), ka maʻi sickle cell (Sickle Cell Disease), a i ʻole nā ​​maʻi ʻē aʻe e hiki ai ke hoʻoulu i ka maʻi puʻupaʻa (Renal Papillary Necrosis), e hahai pono i nā ʻōlelo a kāu kauka. E hele i nā keʻena lapaʻau i ka manawa kūpono. E lawe i nā lāʻau lapaʻau i kuhikuhi ʻia. E hahai i ka ʻai kūpono.
• He mea nui loa ka loaʻa ʻana o nā hoʻokolohua lab e nānā i ka hana o nā puʻupaʻa i nā manawa maʻamau e like me ke kuhikuhi a kāu kauka, a e ʻike mua i nā loli.

He aha ka nui o ka ho'ōla ʻana no kekahi me kēia maʻi?

ʻO kāu wānana e pili ana i ke kumu o ka maʻi, ka nui o ka hōʻino ʻia o nā puʻupaʻa, kou olakino holoʻokoʻa, a me ka wikiwiki o kou hoʻomaka ʻana i ka lāʻau.

• No ka poʻe me ka maʻi diabetes, ʻaʻole paha e maikaʻi iki nā hopena , no ka mea, he maʻi lōʻihi ka maʻi diabetes a ʻaʻole i kaohi maikaʻi ʻia. Inā loaʻa iā ʻoe ka maʻi diabetes, ʻo ka kaohi ʻana iā ia me ka maikaʻi loa e kōkua nui i ka pale ʻana i ka hōʻino ʻia o nā puʻupaʻa.
• I nā hihia koʻikoʻi (Renal Papillary Necrosis), hiki iā ia ke alakaʻi i ka dialysis a me ka hoʻoili ʻana i nā puʻupaʻa . Inā loaʻa ka maʻi, hiki ke hoʻoweliweli i ke ola. Aia ka hiki ke make ma muli o ka hāʻule ʻana o nā puʻupaʻa.
• I loko o ka maʻi cell sickle, ʻo ka renal papillary necrosis kekahi o nā pilikia he nui e hiki ke hana i nā puʻupaʻa. Ke hui pū ʻia kēia mau pilikia a pau, hiki ke hoʻemi nui ʻia ke ola o ka mea maʻi.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​mai hoʻonele i ka manawa a e ʻike pono i ke kauka :

• Inā he koko kou i loko o kou mimi (lilo ka mimi i ʻulaʻula, poni, a ʻeleʻele paha).
• Inā loaʻa iā ʻoe ke kuni a i ʻole ke anu (ʻoi aku hoʻi me nā hōʻailona ʻē aʻe).
• Inā loaʻa iā ʻoe ka ʻeha a i ʻole ke kuni ʻana i ka wā e mimi ai.
• Inā loaʻa iā ʻoe ka ʻeha hou a i ʻole ka ʻeha e ʻoi aku ana ma nā ʻaoʻao ʻelua o kou kua, ma ka ʻāpana ma waena o kou mau iwi ʻūhā a me nā iwi ʻaoʻao (kahi puʻupaʻa).
• Inā loaʻa pinepine iā ʻoe nā maʻi ʻōpū mimi.
• Inā ʻike ʻoe i ka emi ʻana o ka mimi ʻana a i ʻole ka pehu ʻana i kou mau wāwae a me nā kuʻekuʻe wāwae (he mau hōʻailona paha kēia o ka emi ʻana o ka hana o nā puʻupaʻa).

E hoʻomanaʻo, hiki ke hana ʻia kēia mau hōʻailona e nā maʻi ʻē aʻe. Eia nō naʻe, he mea nui e nānā ʻia e ke kauka e ʻike i ke kumu pololei.

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

He ʻōkana koʻikoʻi ko kākou mau puʻupaʻa no ko kākou kino, e hana ana i kahi hana leo ʻole a koʻikoʻi. Kānana lākou i nā huahana ʻōpala a mālama i ke kaulike o ka wai a me ka paʻakai i loko o ke kino. ʻO ka maʻi diabetes i kāohi ʻole ʻia, ka hoʻohana nui ʻana i nā lāʻau ʻeha (NSAID), a me nā ʻano maʻi like ʻole e hōʻino i nā puʻupaʻa, e alakaʻi ana i nā kūlana koʻikoʻi e like me Renal Papillary Necrosis.

ʻO ka mea ʻino loa e pili ana i kēia maʻi, ʻaʻole paha ʻoe e loaʻa i kekahi mau hōʻailona i nā pae mua. No laila, inā he maʻi diabetes kou, he mea hoʻohana pinepine ʻoe i nā NSAID, a i ʻole he mau kumu pilikia ʻē aʻe no ka maʻi puʻupaʻa, e kamaʻilio me kāu kauka e pili ana i nā ala e pale ai i kou mau puʻupaʻa. Ma ka loaʻa ʻana o nā nānā mau ʻana a me ka hahai ʻana i kahi nohona olakino, hiki iā ʻoe ke mālama i kou mau puʻupaʻa i ke olakino. ʻO ka ʻike mua a me ka hana ʻana ka mea maikaʻi loa e hana ai.

ʻO ka puʻupaʻa, ka necrosis papillary renal, ka maʻi puʻupaʻa, ka maʻi diabetes, nā NSAID, ka hāʻule ʻana o ka puʻupaʻa, ka mimi