E ʻike kākou i nā mea āpau e pili ana iā Tarpeyo, kahi lāʻau lapaʻau no ka maʻi puʻupaʻa i kapa ʻia ʻo IgA Nephropathy.

ʻO nā puʻupaʻa kekahi o nā ʻōkana koʻikoʻi loa i loko o ko kākou kino. Akā i kekahi manawa, hiki i nā loli i loko o kā kākou ʻōnaehana pale ponoʻī ke hōʻino i nā puʻupaʻa. ʻO kekahi o ia ʻano maʻi, ʻo ia ka nephropathy immunoglobulin A mua, a i ʻole ka nephropathy IgA wale nō. Ma kēia, hōʻiliʻili kahi antibody i kapa ʻia ʻo IgA i loko o nā puʻupaʻa, e hoʻoulu ai iā lākou e pehu a hana pono ʻole. I kēia lā, e kamaʻilio mākou e pili ana i kēia maʻi a me ka lāʻau lapaʻau kūikawā i kapa ʻia ʻo Tarpeyo i hāʻawi ʻia no ia mea.

Pehea e hana ai ka lāʻau lapaʻau ʻo Tarpeyo?

I ka ʻōlelo maʻalahi, hoʻomaka ka IgA Nephropathy i ka wā e hoʻomaka ai ko mākou kino e hana i nā antibodies IgA maʻamau ʻole (IgA1). ʻO ka maʻamau, ua like nā antibodies me nā kiaʻi o kā mākou ʻōnaehana pale. Mālama lākou iā mākou mai nā mea e like me ka bacteria a me nā virus. Akā i loko o kēia maʻi, aia kahi kīnā liʻiliʻi i nā antibodies IgA i hana ʻia. Hoʻopili kēia mau antibodies hemahema a hana i nā puʻupuʻu nui. Nānā kā mākou ʻōnaehana pale i kēia mau puʻupuʻu me he mea lā he ʻenemi lākou. No laila, hoʻomaka ka ʻōnaehana pale e hakakā i kēia mau puʻupuʻu. Hana ʻia kēia kaua i loko o nā puʻupaʻa. Hoʻoulu kēia i ka mumū i loko o nā ʻāpana kānana palupalu i loko o nā puʻupaʻa, i kapa ʻia ʻo glomeruli. I ka hala ʻana o ka manawa, hoʻoulu kēia mumū i ka ʻeha ma kēlā mau wahi a hōʻino i nā puʻupaʻa. ʻAʻole paha e ʻike nui ka ʻoluʻolu ʻole o ke kanaka me kēia maʻi i ka wā mua. Eia nō naʻe, i ka hala ʻana o ka manawa, hiki ke ʻike ʻia kēia mau hōʻailona ma muli o ka hōʻino ʻia o nā puʻupaʻa. Hoʻōla pinepine nā kauka i kēia maʻi ma o ka kaohi ʻana i nā hōʻailona e like me ke koko kiʻekiʻe a me ka hāʻawi ʻana i nā lāʻau lapaʻau e kaohi ana i ka ʻōnaehana pale. Hoʻokomo pū kēia i nā lāʻau lapaʻau e like me nā immunosuppressants a me nā corticosteroids. Eia naʻe, hiki i kēia mau lāʻau lapaʻau maʻamau ke loaʻa nā hopena ʻaoʻao makemake ʻole ke lawe ʻia i ka wā lōʻihi. ʻO kēia kahi e komo mai ai ka lāʻau Tarpeyo . He corticosteroid nō hoʻi ʻo Tarpeyo, akā ʻo kāna mea kūikawā, ʻo ia ka hele ʻana i kahi ponoʻī kahi i hana ʻia ai nā antibodies IgA pilikia. Hana ʻia nā antibodies ma kahi ʻāpana kikoʻī o ko mākou ʻōpū i kapa ʻia ʻo ileum. Hele pololei ʻo Tarpeyo ma laila a hōʻemi i ka hana ʻana o kēia IgA1 hewa. No laila, ua hoʻemi ʻia ka mumū a me ka hōʻino ʻana i nā puʻupaʻa, a ua hoʻemi ʻia hoʻi nā hopena ʻaoʻao lōʻihi o nā lāʻau steroid maʻamau.

Pehea e pono ai iaʻu ke hoʻohana i kēia lāʻau lapaʻau?

He lāʻau lapaʻau ʻo Tarpeyo i loaʻa i ke ʻano capsule. Pono e lawe ʻia i kēlā me kēia kakahiaka, ma ka liʻiliʻi he hola ma mua o ka ʻai ʻana .

• Mai uhaʻi, nau, a wili paha i ka lāʻau. Pono e ale ʻia a pau.
• Mai ʻai i ka ʻāpala a inu paha i ka wai ʻāpala i ka wā e lawe ana i kēia lāʻau. E kamaʻilio mākou no ke kumu ma hope.

He mea nui loa: Mai ho'ōki i ka lawe ʻana i kēia lāʻau lapaʻau me ke kamaʻilio ʻole ʻana me kāu kauka. Ke hoʻomau ʻoe i ka lawe ʻana i nā corticosteroids e like me Tarpeyo, e hoʻōki kou kino i ka hana ʻana i nā hormones steroid āna e hana maoli ai. Inā hoʻōki koke ʻoe i ka lawe ʻana i ka lāʻau lapaʻau, e nalowale ana kou kino i ka nui o nā steroids e pono ai a hiki iā ʻoe ke ʻike i nā hōʻailona haʻalele. No ka laʻana, hiki iā ʻoe ke ʻike i ka luhi nui, nā ʻeha kino, ka nausea, ke koko haʻahaʻa, a me nā poʻo ʻeha. No laila, inā hoʻōki ʻoe i ka lawe ʻana i ka lāʻau lapaʻau, pono ʻoe e hana mālie ma ka hoʻēmi ʻana i ka nui (tapering) . E haʻi aku kāu kauka iā ʻoe i ke ala kūpono e hana ai i kēia.

Pehea i aʻo ʻia ai nā pono o kēia lāʻau lapaʻau?

Ma kahi noiʻi nui e ʻike i ka palekana a me ka pono o Tarpeyo, ua hoʻohālikelike ʻia me kahi placebo. ʻO kahi placebo kahi pila dummy ʻaʻohe lāʻau lapaʻau. ʻO kēia ke ʻike i ka ʻokoʻa ma waena o ka poʻe i lawe i ka lāʻau lapaʻau maoli a me ka poʻe i lawe i ka pila dummy. Loaʻa i nā mea komo a pau i ke aʻo ʻana ka IgA nephropathy a loaʻa iā lākou ka protein keu i loko o kā lākou mimi. Ua lawe pū lākou a pau i nā lāʻau lapaʻau koko, e like me nā ACE inhibitors a i ʻole ARBs, e hoʻemi ana i ke kaomi ma nā puʻupaʻa. Ua koho ʻia nā mea komo ma muli o ʻelua mau kumu:

• ʻO ka lakio protein-to-creatinine mimi (UPCR): Ke ana kēia i ka nui o ka protein i hoʻokuʻu ʻia i loko o ka mimi i loko o 24 mau hola.
• Ka helu kānana glomerular i manaʻo ʻia (eGFR): Ke ana kēia i ka maikaʻi o ka hana ʻana o kou mau puʻupaʻa a me ka maikaʻi o kā lākou kānana ʻana i nā ʻōpala. Ua emi iki ka hana o nā puʻupaʻa o ka poʻe i loko o ke aʻo ʻana.

Ma kēia haʻawina, ua hāʻawi ʻia kekahi hui iā Tarpeyo no 9 mau mahina, a ua hāʻawi ʻia kekahi hui i kahi placebo. Ma hope o 9 mau mahina, ua hoʻōki ʻia ka lāʻau lapaʻau a ua nānā ʻia lākou no 15 mau mahina ʻē aʻe.

He aha nā pono i hōʻike ʻia ma nā haʻawina?

Ua hōʻike ʻia ma ke aʻo ʻana ua emi iki ka hōʻino ʻana o nā puʻupaʻa o ka poʻe i lawe iā Tarpeyo ma mua o ka poʻe i lawe i ka placebo. Ua hoʻomau ʻia kēia pono ma hope o 9 mau mahina o ka lawe ʻana i ka lāʻau.

Ua emi nā pae protein i loko o ka mimi

I ka pau ʻana o 9 mau mahina, ua emi iho ka nui o ka protein i loko o ka mimi o ka poʻe e lawe ana iā Tarpeyo ma 35%, ke hoʻohālikelike ʻia me 5% wale nō i ka poʻe e lawe ana i ka placebo. Ua mālama ʻia kēia emi ʻana no 24 mau mahina.

Hana puʻupaʻa (eGFR)

I ka pau ʻana o 24 mau mahina, ʻoi aku ka liʻiliʻi o ka emi ʻana o ka hana o nā puʻupaʻa o ka poʻe i lawe iā Tarpeyo ma mua o ka poʻe i lawe i ka placebo. ʻO ka waiwai maikaʻi (+) ke ʻano o ka hoʻomaikaʻi ʻana i ka hana o nā puʻupaʻa, a ʻo ka waiwai maikaʻi ʻole (-) ke ʻano o ka ʻino. Ua hōʻike kēia haʻawina e hiki i ka lawe ʻana iā Tarpeyo no 9 mau mahina ke hoʻolohi i ka hōʻino ʻana i nā puʻupaʻa. Hiki i kēia ke kōkua i ka kaohi ʻana i nā hōʻailona a hoʻopaneʻe i ka hāʻule ʻana o nā puʻupaʻa. Akā e hoʻomanaʻo he ʻokoʻa paha kēia mau hopena mai kēlā kanaka a kēia kanaka.

Pehea e pale ai a mālama i nā hopena ʻaoʻao?

He lāʻau lapaʻau ʻo Tarpeyo e kāohi ana i ka ʻōnaehana pale, no laila ʻoi aku ka nui o kou loaʻa ʻana i nā maʻi. Hiki iā ʻoe ke loaʻa pinepine i ke anu, ka maʻi palū, a me nā maʻi ʻōpū mimi. E noho mamao aku mai ka poʻe i loaʻa i nā maʻi lele e like me ka moa a me ka measles. ʻO ke ala maikaʻi loa e pale aku ai i nā maʻi, ʻo ia ka holoi pinepine ʻana i kou mau lima a noho mamao aku mai ka poʻe maʻi. E kamaʻilio me kāu kauka e pili ana i ka loaʻa ʻana o nā lāʻau pale. E kāhea koke i kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona o ka maʻi:

• Kuni a i ʻole ke anu
• ʻEha kino
• Kuke
• Luhi nui
• ʻEha poʻo mau
• Nā loli o ka ʻike a i ʻole ka nalowale o ka hoʻomanaʻo
• He hahau ʻeha

Hiki iā Tarpeyo ke hoʻoulu i ka pehu a i ʻole ke koko kiʻekiʻe . E kamaʻilio me kāu kauka e pili ana i kahi nohona olakino, me ka ʻai a me ka hoʻoikaika kino. ʻO ka hōʻemi ʻana i ka paʻakai i kāu ʻai, ka inu ʻana i ka wai he nui, a me ka hana ʻana i nā hoʻoikaika kino māmā e like me ka hele wāwae e hiki ke kōkua i ka hōʻemi ʻana i ka pehu a me ka kaohi ʻana i ke koko. ʻO nā hopena ʻaoʻao maʻamau ʻē aʻe e pili ana i ka nausea, ka ʻeha o ka ʻōpū, nā ʻeha ʻiʻo, ka ʻāʻī, a me nā poʻo ʻeha . Inā loaʻa iā ʻoe ka ʻāʻī, e hahai i kahi hana mālama ʻili maikaʻi, e like me nā mea hoʻomaʻemaʻe palupalu a me nā moisturizers ʻaila ʻole. ʻAʻole kēia nā hopena ʻaoʻao āpau. Inā loaʻa iā ʻoe kekahi mau hōʻailona e hoʻopilikia iā ʻoe, e kamaʻilio me kāu kauka e pili ana iā lākou.

He aha nā hoʻokolohua e pono e hana ʻia i ka wā e lawe ana i ka lāʻau lapaʻau?

E kauoha ana kāu kauka i nā hoʻokolohua like ʻole e ʻike ai pehea e pane ai kou kino i ka lāʻau lapaʻau. Eia nā mea nui:

• Ana ʻana o ke koko
• ʻO ka Urinalysis e nānā i ka nui o ka protein i loko o ka mimi
• Nā hoʻāʻo koko e nānā i ka hana o ka puʻupaʻa
• Hoʻāʻo koko no ka maʻi hepatitis B

He aha nā mea ʻē aʻe e hiki ke launa pū me kēia lāʻau lapaʻau?

Hiki i kekahi mau lāʻau lapaʻau a me nā meaʻai ke hoʻopilikia i ke ʻano o ka hana a Tarpeyo. No laila, he mea nui loa ia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (me nā huaora a me nā huahana lāʻau) . E makaʻala loa i kēia mau mea:

• ʻO kekahi mau lāʻau antifungal a me nā lāʻau antibiotic (e.g., clarithromycin (Biaxin), itraconazole (Sporanox), ketoconazole (Nizoral))
• ʻO kekahi mau lāʻau lapaʻau i hoʻohana ʻia no ka maʻi HIV
• Wai huaʻala a wai huaʻala paha

ʻAʻole kēia he papa inoa piha, no laila e haʻi pono i kāu kauka e pili ana i nā mea āpau āu e lawe ai.

E ʻike pehea e hiki ai iā ʻoe ke loaʻa i kēia lāʻau lapaʻau.

He lāʻau lapaʻau kūikawā ʻo Tarpeyo. ʻO ia hoʻi, he pipiʻi a hoʻohana ʻia no nā kūlana olakino kikoʻī. No laila, ʻaʻole paha e loaʻa ma nā hale kūʻai lāʻau lapaʻau āpau. ʻO ka maʻamau, loaʻa kēia ʻano lāʻau lapaʻau ma nā hale kūʻai lāʻau lapaʻau haukapila a i ʻole nā ​​hale kūʻai lāʻau lapaʻau kūikawā. Na kāu kauka e alakaʻi iā ʻoe ma ke kaʻina hana o ka loaʻa ʻana o kēia lāʻau lapaʻau a me kahi e loaʻa ai. ʻO ka nephropathy IgA, Tarpeyo, maʻi puʻupaʻa, protein i loko o ka mimi, eGFR, corticosteroid, ʻōnaehana pale