Ua like nā puʻupaʻa i loko o ko kākou kino me nā limahana leo ʻole, ʻeā? Hana lākou i ka nui o ka hana me ka ʻike ʻole ʻia e kākou. Hoʻomaʻemaʻe lākou i ko kākou koko i ka lā a pau, kāohi i ka nui o ka wai i loko o ke kino, a hoʻoneʻe i nā mea ʻōpala pono ʻole. Akā i kekahi manawa, loaʻa pū kekahi mau pilikia i kēia mau puʻupaʻa. I kēia lā e kamaʻilio kākou e pili ana i kahi maʻi e hoʻopilikia ana i ia mau puʻupaʻa. ʻO ia ka maʻi renal parenchymal, a i ʻole ma ka ʻōlelo Pelekania `(Renal Parenchymal Disease)` . He paʻakikī iki paha kēia inoa ke lohe ʻoe, akā e hoʻomaopopo maʻalahi kākou.
He aha ka maʻi Renal Parenchymal?
I ka ʻōlelo maʻalahi, he hui kēia o nā kūlana e hōʻino ai i nā puʻupaʻa. Hoʻopilikia nui ia i ka ʻāpana o ka puʻupaʻa i kapa ʻia ʻo "Parenchyma" . I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o kēia parenchyma. ʻO ia hoʻi, nā ʻāpana nui o ka puʻupaʻa e hana ana, a i ʻole e kōkua i ka hana o ka puʻupaʻa. ʻElua ʻāpana nui o kēia parenchyma:
1. Renal Cortex : ʻO kēia ka ʻāpana waho loa o ka puʻupaʻa. Hoʻomaka nā ʻāpana kānana liʻiliʻi i loko o ko kākou mau puʻupaʻa, i kapa ʻia ʻo nephrons , ma ʻaneʻi. Ua like kēia mau nephrons me nā kānana liʻiliʻi. Loaʻa iā lākou ʻelua ʻāpana. ʻO kekahi he kīʻaha koko i kapa ʻia he glomerulus . ʻO kekahi he ʻōmole liʻiliʻi i kapa ʻia he renal tubule .
- Hoʻokaʻawale mua ʻia ke koko e ka glomeruli .
- ʻO ka hana o nā renal tubules ka hoʻopili hou ʻana i ka wai, nā meaolaola, a me nā minelala e pono ai ke kino a hoʻokuʻu aku i nā huahana ʻōpala pono ʻole ma o ka mimi.
- Eia kekahi, hana pū ka cortex o nā puʻupaʻa i kahi hormone i kapa ʻia ʻo 'Erythropoietin (EPO) . Kōkua kēia hormone '(EPO)' i ko kākou 'Bone Marrow' e hana i nā hunaola koko ʻulaʻula.
2. Renal Medulla : Aia kēia ma ka ʻaoʻao o loko o ka puʻupaʻa. Aia ka hapa nui o nā nephrons ma kēia ʻāpana.
No laila, kapa nā kauka i kekahi kūlana e hoʻopilikia ana i ka cortex a i ʻole ka medulla o ka puʻupaʻa he maʻi renal parenchyma. Ua kapa ʻia hoʻi ia ma nā inoa ʻē aʻe, no ka laʻana, nā maʻi bilateral renal parenchyma, a me ka maʻi kidney parenchymal.
He aha nā ʻano nui o kēia maʻi?
Hiki ke puʻunaue ʻia kēia maʻi i ʻelua ʻano nui:
- Ka maʻi Renal Parenchymal ʻoi : Hoʻomaka koke kēia.
- Ka maʻi Renal Parenchymal Mau Loa : Holo mālie kēia a mau no ka manawa lōʻihi.
He mea weliweli anei kēia maʻi?
Aia maoli nō ia i ke kumu a me ke koʻikoʻi o ke kūlana. Hiki i kekahi mau hihia akahai ke hoʻomaikaʻi me ka mālama ʻana. Akā i nā hihia koʻikoʻi,Hiki iā ia ke holomua i ka `Kidney Failure.` E like me kou ʻike, ʻo ka hemahema o ka puʻupaʻa he mea ia e hoʻoweliweli ai i ke ola inā ʻaʻole mālama ʻia.
He aha nā hōʻailona mua e hiki ke ʻike ʻia?
I ka manawa pinepine, ʻaʻohe hōʻailona nui i nā pae mua o kēia maʻi. ʻO ia ka mea e hopohopo iki ai. Akā i ka holomua ʻana o ka maʻi a me ka nalowale ʻana o ka hana o kou mau puʻupaʻa, hiki iā ʻoe ke ʻike i nā hōʻailona e like me kēia:
- Ke koko i loko o ka mimi (Hematuria)
- ʻIli maloʻo a me ka ʻili ʻāʻī
- Manaʻo o ka luhi nui
- Makemake nui
- Ka emi ʻana o ka nui o nā hunaola koko ʻulaʻula i loko o ke koko (Anemia)
- Ka luaʻi a me ka luaʻi
- Ke kahe ʻana o ka mimi ma mua o ka maʻamau
- ʻO ka pehu a puni nā maka
- Ka pehu ʻana o nā lima, nā wāwae, a me nā kuʻekuʻe wāwae (Edema)
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, he mea nui loa e ʻike i ke kauka.
He aha ke kumu o kēia?
ʻO nā kumu nui ʻelua o ka maʻi puʻupaʻa mau loa, ʻo ia ke koko kiʻekiʻe a me ka maʻi diabetes . Eia nō naʻe, aia paha kekahi mau kumu ʻē aʻe:
- Nā maʻi Autoimmune , e like me Lupus Nephritis
- ʻO Glomerulonephritis (ka mumū o nā ʻāpana kānana o nā puʻupaʻa)
- ʻO ke Kanesa o nā Pūnaʻi
- ʻO ka maʻi puʻupaʻa Polycystic ( nā cysts puʻupaʻa)
- ʻO ka maʻi ʻeha o ke kelepona ʻokiʻoki
ʻO nā mea e hiki ai ke hoʻoulu i ka maʻi parenchymal kidney koke (Acute):
- Ka hopena maʻi ʻaleka koʻikoʻi (Anaphylaxis)
- Nā maʻi bacteria
- Nā Pōhaku Pūpū
- Nā ʻōpū puʻupaʻa
- ʻO ka Pulmonary Embolism (kahi ʻōpū koko i loko o kahi kīʻaha koko e alakaʻi ana i nā māmā)
- `Maʻiwai Nui`
- Nā maʻi viral
Hiki i kekahi mau lāʻau lapaʻau ke hana i kēia kūlana `(Acute)`. Nā laʻana:
- Nā mea hoʻopaʻa i ka enzyme hoʻololi-angiotensin (ACE Inhibitors)
- Nā mea pale i ka mea loaʻa Angiotensin II (ARBs)
- Nā lāʻau anti-inflammatory nonsteroidal (NSAIDs) (e.g. Ibuprofen, Diclofenac)
ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?
Hiki i kekahi ke loaʻa i kēia maʻi, akā ʻoi aku kou pilikia inā loaʻa iā ʻoe kēia mau mea:
- Inā loaʻa i kekahi o ka ʻohana kēia maʻi parenchyma puʻupaʻa
- Inā loaʻa iā ʻoe ka maʻi diabetes
- Inā he maʻi puʻuwai kou
- Inā loaʻa iā ʻoe ke 'Kikokikona Kiʻekiʻe'
Eia kekahi, inā ʻoe ma luna o 60 mau makahiki a hoʻohana mau i nā lāʻau ʻeha NSAID over-the-counter (OTC) a me nā lāʻau lapaʻau i kauoha ʻia, ʻoi aku ka kiʻekiʻe o kou pilikia.
He aha nā pilikia e hiki mai ana o kēia maʻi?
Inā ʻaʻole i kāohi pono ʻia kēia maʻi, hiki ke loaʻa nā pilikia like ʻole. ʻO kekahi o lākou:
- Hoʻonui ʻia ka waikawa o nā wai o ke kino (Metabolic Acidosis)
- Hoʻonui ʻia ka nui o ka phosphate (phosphorus) i loko o ke koko (Hyperphosphatemia)
- Hoʻonui ʻia ka nui o ka potassium i loko o ke koko (Hyperkalemia)
- Ua emi ka helu o nā hunaola koko ʻulaʻula (anemia)
- ʻEha i hoʻokumu ʻia e ka waiho ʻana o ka uric acid i loko o nā hono (Gout)
- ʻOsteoporosis
- ʻŌnaehana pale kino nāwaliwali
He mea nui: ʻAʻole e ʻike nā kānaka a pau i kēia mau pilikia. Eia nō naʻe, inā ʻoe e mālama i ka maʻi a loaʻa ka lāʻau kūpono, hiki iā ʻoe ke pale aku iā lākou.
Pehea ʻoe e ʻike pololei ai i kēia maʻi? (Diagnosis)
E nīnau ke kauka e pili ana i kāu mau hōʻailona, e nānā i kāu mōʻaukala olakino, e nīnau e pili ana i nā lāʻau lapaʻau āu e lawe ai, a hana i kahi hoʻokolokolo kino. A laila, inā manaʻo lākou he maʻi kou, e kauoha lākou i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona. ʻO kekahi o kēia mau mea:
- Nā Hoʻāʻo Hana Pūpū : ʻO kēia mau mea e komo pū me nā hoʻāʻo koko a me nā hoʻāʻo mimi. Nānā nā hoʻāʻo koko i kāu helu kānana glomerular (eGFR) i manaʻo ʻia a me ka pae creatinine serum . Nānā nā hoʻāʻo mimi no ka proteinuria a me ke koko i loko o ka mimi.
- Nā hoʻāʻo kiʻi : Hiki i kēia ke kōkua i nā kauka e loaʻa kahi kiʻi maopopo o ka nui, ke ʻano, a me ke ʻano o nā puʻupaʻa. Hiki iā lākou ke kauoha i kahi scan ultrasound , kahi scan MRI (Magnetic Resonance Imaging) , a i ʻole kahi scan CT (Computed Tomography) .
- Biopsy Kidney : Ma kēia hoʻāʻo, lawe ke kauka i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupaʻa a hoʻāʻo iā ia ma kahi keʻena hoʻokolohua. Hiki i kēia biopsy ke hāʻawi i ka ʻike i hiki ʻole i nā hoʻokolohua ʻē aʻe.
Pehea e mālama ʻia ai?
ʻO ka mālama ʻana i ka maʻi parenchymal renal e pili ana i kekahi mau kumu. ʻO kēia mau mea:
- He aha ke kumu maoli o ka maʻi a pehea ke koʻikoʻi o ia maʻi.
- Kou makahiki a me kou olakino holoʻokoʻa.
Hiki i kāu mau koho lapaʻau ke komo pū me:
- E hōʻole i ka hoʻohana ʻana i nā lāʻau lapaʻau NSAID a me nā lāʻau ʻē aʻe e hiki ke hoʻonui i ka maʻi puʻupaʻa.
- E hōʻole loa i ka hoʻohana ʻana i ka paka (puhi paka, vaping, nau paka, a pēlā aku).
- Ke komo ʻana i ka hoʻoikaika kino maʻamau.
- Ka mālama ʻana i kahi kaumaha olakino e kūpono iā ʻoe.
- ʻO ka lawe ʻana i nā lāʻau lapaʻau e pono ai e kaohi i ke koko, ka cholesterol, a me ka maʻi diabetes.
- E kamaʻilio me kahi Renal Dietitian e hoʻomohala i kahi papaʻai e pono ai no nā puʻupaʻa. Hiki i kēia ke komo pū me kahi papaʻai e hōʻemi ana i ka protein, hoʻohaʻahaʻa i nā pae cholesterol koko, a kaupalena i ka paʻakai (sodium) a me ka potassium.
Inā koʻikoʻi ka maʻi, pono paha nā lāʻau lapaʻau penei:
- ʻO Corticosteroids (kahi ʻano lāʻau lapaʻau e hōʻemi ai i ka mumū)
- Dialysis (ka hoʻomaʻemaʻe ʻana i ke koko me ke kōkua o kahi mīkini ke hana pono ʻole nā puʻupaʻa)
- Nā Immunosuppressants (nā lāʻau lapaʻau e hōʻemi i ka hana o ka ʻōnaehana pale)
- ʻO ke kāpili ʻana o nā puʻupaʻa
Inā loaʻa iaʻu kēia maʻi, he aha kaʻu e manaʻo ai?
Inā loaʻa iā ʻoe kēia maʻi, pono ʻoe e hana pū me kāu hui lapaʻau e kāohi i ka hōʻino ʻana i kou mau puʻupaʻa a mālama i kā lākou hana no ka lōʻihi e hiki ai. Eia kekahi mau mea e hana ai:
- Ka mālama ʻana i kahi papaʻai e pono ai nā puʻupaʻa.
- E nānā mau i kou pae kō koko a me ke koko.
- E kipa aku i kahi nephrologist a e nānā pinepine i kou mau puʻupaʻa.
- Ke lawe nei i ka lāʻau lapaʻau i kauoha ʻia e ke kauka me ka pololei a me ka manawa kūpono.
Pehea ka lōʻihi e hiki ai iā ʻoe ke ola me kēia maʻi?
He paʻakikī ke hāʻawi i hoʻokahi pane i kēia nīnau. No ka mea, hilinaʻi ia i nā mea he nui, e like me ke koʻikoʻi o ka maʻi, kou makahiki, ke kāne, a me ke olakino holoʻokoʻa. Inā ua hōʻino nui ʻia kou mau puʻupaʻa, hiki ke hoʻemi ʻia kou manaʻolana ola. Inā ʻoe ma ka dialysis, manaʻo ʻia ʻoe e ola no 5 a 10 mau makahiki.
Akā e hoʻomanaʻo! He awelika wale nō kēia. He nui ka poʻe e ola lōʻihi me ka mālama kūpono a me ka hoʻoili ʻana i nā puʻupaʻa. Hiki i ka poʻe me ka maʻi puʻupaʻa hope loa ke ola no 20-30 mau makahiki. No laila, e kamaʻilio me kāu kauka a aʻo hou e pili ana i kou kūlana.
Aia kekahi mau ala e pale aku ai i kēia maʻi? (Ka pale ʻana)
ʻOiai ʻaʻole hiki ke pale ʻia nā kumu āpau, hiki iā ʻoe ke hōʻemi i kou pilikia o ka hoʻomohala ʻana i ka maʻi ma o ka hana ʻana i kēia mau mea:
- E hoʻoikaika kino ikaika ma ka liʻiliʻi he ʻelima mau lā o ka pule, no ka liʻiliʻi he 30 mau minuke i ka lā.
- Ke kaupalena nei i ka inu ʻana i ka waiʻona.
- Ka mālama ʻana i kahi kaumaha olakino e kūpono iā ʻoe.
- Inā he nui kou pilikia o ka loaʻa ʻana o nā maʻi puʻupaʻa (e like me ka maʻi diabetes, ke koko kiʻekiʻe), e ʻike pinepine i ke kauka no nā nānā kino.
- E hōʻole loa i ka puhipaka.
- Ka hōʻemi ʻana i ka nui o ka paʻakai i hoʻohui ʻia i nā meaʻai.
- ʻO ka NSAIDE hoʻohana wale i nā lāʻau ʻeha e like me ke kuhikuhi a ke kauka.
He aha nā meaʻai e pono ai ke kanaka me kēia maʻi e hōʻalo?
Inā loaʻa iā ʻoe ka maʻi parenchymal renal, he mea nui loa ia e ʻike i kahi meaʻai renal . E hana ʻo ia i kahi papaʻai kūpono iā ʻoe a maikaʻi hoʻi no kou mau puʻupaʻa. Pono ʻoe e kaupalena i nā meaʻai i kiʻekiʻe i ka paʻakai, ka protein, ka phosphorus, a me ka potassium. Eia kekahi mau laʻana:
- ʻAvokado
- Maiʻa
- Meaʻai i loko o ka pahu
- Nā meaʻai māmā e like me nā ʻuala palai a me nā pretzels
- Nā hua citrus a me nā wai, e like me nā ʻalani
- Nā hua maloʻo
- Nā ʻiʻo i hana ʻia (e like me nā sausage, meatballs)
- ʻO ka palaina
He mea nui: ʻAʻole paha no nā kānaka āpau kēia papa inoa. E noi i kāu meaʻai meaʻai no nā ʻōlelo aʻoaʻo kikoʻī e pili ana i nā meaʻai maikaʻi iā ʻoe a me nā mea āu e pale aku ai.
Āhea ʻoe e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole kekahi maʻi ʻē aʻe e hiki ai ke alakaʻi i ka maʻi puʻupaʻa, e ʻike pinepine i kāu kauka no nā nānā ʻana. ʻO ka ʻike mua ʻana a me ka hoʻomaopopo ʻana i kāu mau kumu pilikia e hiki ke kōkua i ka pale ʻana i ka hōʻino hou ʻana i kou mau puʻupaʻa.
I ka manawa hea ʻoe e pono ai e hele i ka Emergency Treatment Unit (ETU) ?
ʻIke pinepine ʻia nā hōʻailona o ka maʻi parenchymal renal ma hope o ka hōʻino nui ʻana i nā puʻupaʻa. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, e ʻike koke i ke kauka:
- Inā wili pinepine ʻia nā ʻiʻo
- Inā he makemake kou
- Inā ʻoe e luhi loa
- Inā pilikia ʻoe i ka noʻonoʻo ʻana a i ʻole ka hiamoe ʻana
- Inā he ʻili ʻeha kou
- Inā loaʻa iā ʻoe nā hiccups ʻaʻole e pau
- Inā pehu kou mau lima, kuʻekuʻe wāwae, a wāwae paha
- Inā ʻoe e mimi ana ma mua o ka maʻamau
He aha nā nīnau āu e nīnau ai i ke kauka?
Ke hele ʻoe i ke kauka, he mea kōkua paha ke nīnau ʻana i kēia mau nīnau:
- Pehea ʻoe e ʻike ai inā he maʻi renal parenchymal koʻu?
- Pehea ke koʻikoʻi?
- He aha nā lāʻau lapaʻau āu e paipai nei?
- He aha kaʻu e hana ai e pale aku i koʻu mau puʻupaʻa?
- Hiki iā ʻoe ke paipai i kahi meaʻai loea no nā maʻi puʻupaʻa?
- Hiki iā ʻoe ke haʻi mai iaʻu e pili ana i kahi hui kākoʻo e kōkua ana i nā poʻe me kēia maʻi?
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
ʻO ka maʻi Renal Parenchymal kahi maʻi e hoʻopilikia ai i ka hana o kou mau puʻupaʻa. ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka mālama ʻana i ka maʻi e mālama i ka hana o nā puʻupaʻa no ka lōʻihi e hiki ai. Noho ka nui o ka poʻe me kēia maʻi no nā makahiki he nui.
Eia nō naʻe, ke loaʻa iā ʻoe kahi maʻi e like me kēia a pono ʻoe e mālama mau ʻia, hiki iā ʻoe ke huhū a huhū. He mea maʻamau kēia. ʻO ke kamaʻilio ʻana e pili ana i kēia me kou ʻohana hilinaʻi a me nā hoaaloha hiki ke kōkua iā ʻoe. Hiki iā ʻoe ke hui pū me nā hui kākoʻo no ka poʻe me kēia maʻi. Inā he mau nīnau kāu, mai makaʻu e kamaʻilio me kāu kauka. E kōkua lākou iā ʻoe. ʻAʻole ʻoe hoʻokahi!
ʻO ka maʻi puʻupaʻa, ka maʻi parenchymal renal, parenchyma puʻupaʻa, hana puʻupaʻa, hāʻule ʻana o ka puʻupaʻa, maʻi puʻupaʻa, hana puʻupaʻa, maʻi kō, koko kiʻekiʻe
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