Ua noʻonoʻo paha ʻoe i ka ʻōnaehana kānana kupaianaha i loko o ko kākou kino? E like me ke kānana ʻaila i loko o ke kaʻa, he ʻōkana koʻikoʻi ko kākou mau puʻupaʻa e kānana ana i nā ʻōpala mai ko kākou kino, hoʻomaʻemaʻe i ko kākou koko, a mālama iā kākou i ke olakino. Akā i ka hapa nui o ka manawa, ʻaʻole mākou e noʻonoʻo nui iā lākou a hiki i ka wā e hewa ai kekahi mea. Malia paha ua pehu kou mau wāwae a ua manaʻo ʻoe e make ana ʻoe. He mau hōʻailona mua paha kēia o ka maʻi puʻupaʻa. No laila i kēia lā, e kamaʻilio kākou e pili ana i kēia ma ke ʻano maʻalahi a pololei.
He aha ka hana a nā puʻupaʻa e hāʻawi ai i ko kākou kino?
Loaʻa iā kākou a pau nā puʻupaʻa ʻelua. Aia lākou ma nā ʻaoʻao ʻelua o ko kākou kua, ma luna pono o ko kākou pūhaka. ʻAʻole he hana liʻiliʻi ka hana a kēia mau ʻōkana liʻiliʻi ʻelua.
I ka ʻōlelo maʻalahi, hele ke koko a pau i loko o ko kākou kino ma o kēia mau puʻupaʻa a hoʻomaʻemaʻe ʻia i kēlā me kēia 30 mau minuke. ʻO ia hoʻi, e noʻonoʻo wale i ka nui o kēia hana i ka lā!
Inā olakino nā puʻupaʻa, e hana lākou i kēia mau mea:
| Nā hana nui o ka puʻupaʻa | He wehewehe maʻalahi |
|---|---|
| Kānana ʻōpala | Hoʻokuʻu ʻia nā mea ʻawahia i hōʻiliʻili ʻia i loko o ke koko ma muli o ka meaʻai a mākou e ʻai ai, nā lāʻau lapaʻau a mākou e lawe ai, a me nā hana o ke kino ma o ka mimi. |
| Ke kaulike ʻana i ka wai a me nā minelala | Hoʻokele ia i ka nui o ka wai i loko o ke kino, mālama i ka nui o nā minelala e pono ai e like me ka sodium a me ka potassium, a hoʻoneʻe i nā mea keu. |
| Kaohi ʻana i ke koko | Hoʻopuka ia i kahi hormone i kapa ʻia ʻo renin, ka mea e kōkua ai i ka hoʻokele ʻana i ko mākou koko. |
| Ka hana ʻana o nā hunaola koko ʻulaʻula | Hoʻopuka ia i kahi hormone i kapa ʻia ʻo erythropoietin, kahi e hōʻailona ai i ke kino e hana i nā hunaola koko ʻulaʻula. ʻO kēia ka mea e pale ai i ka anemia. |
| Hoʻoulu ʻana i ka huaora D | Hoʻololi nā puʻupaʻa i ka wikamina D, ka mea nui no ka mālama ʻana i ko kākou mau iwi i ikaika, i kona ʻano hana. |
Akā i ka wā e hōʻino ʻia ai nā puʻupaʻa , ʻaʻole hana pono kēia kaʻina hana. A laila hoʻomaka nā huahana ʻōpala a me ka wai keu e hōʻiliʻili i loko o ke kino. Hiki i kēia ke hana i nā mea e like me nā wāwae pehu , ka nausea , ka nāwaliwali , ka insomnia , a me ka paʻakikī o ka hanu ʻana . Inā ʻaʻole mālama pono ʻia, hiki i kēia hōʻino ke ʻoi aku ka ʻino a hiki i nā puʻupaʻa ke hāʻule loa. Hiki iā ia ke hoʻoweliweli i ke ola.
He aha nā ʻano nui o nā maʻi puʻupaʻa?
Aia kekahi mau ʻano nui o nā maʻi puʻupaʻa . E nānā kākou iā lākou.
Maʻi Puʻupaʻa Mau Loa (CKD)
ʻO kēia ke ʻano maʻamau. ʻO CKD kahi kūlana e nalowale mālie ai kou mau puʻupaʻa i ko lākou hiki ke kānana i nā mea ʻawahia a me ke kahe keu mai kou koko. ʻAʻole ia e hana koke ʻia, akā e ulu mālie ana i ka hala ʻana o ka manawa. ʻO ka mea weliweli loa o kēia, ʻaʻohe hōʻailona i nā pae mua.
Hiki i ka mālama kūpono ke hoʻolohi i ka holomua o kēia maʻi. Inā ʻaʻole mālama ʻia, hiki i ka maʻi ke holomua i ka End-Stage Renal Disease (ESRD). Pono paha ka dialysis a i ʻole ka hoʻoili ʻana i ka puʻupaʻa. ʻO ka maʻi diabetes a me ke koko kiʻekiʻe nā kumu nui ʻelua o CKD.
Nā ʻano maʻi puʻupaʻa ʻē aʻe
- ʻO ka maʻi puʻupaʻa Polycystic: He maʻi hoʻoilina kēia. Hoʻokumu ʻia nā cysts piha i ka wai ma nā puʻupaʻa. Hoʻemi kēia i ka hiki o nā puʻupaʻa ke kānana i nā huahana ʻōpala.
- Lupus Nephritis: He maʻi autoimmune ʻo Lupus kahi e hoʻouka ai ka ʻōnaehana pale ponoʻī o ke kino i nā hunaola olakino. He kūlana kēia e kū mai ana i ka wā e hoʻouka ai ka ʻōnaehana pale i nā puʻupaʻa.
- ʻO ka Glomerulonephritis:Ka hōʻino ʻana i nā kānana liʻiliʻi (glomeruli) i loko o nā puʻupaʻa. ʻO kēia ke kumu o ka pau ʻana o ka hana pono ʻana o nā puʻupaʻa. Hiki ke loaʻa kēia ʻano ma hope o kekahi mau ʻano maʻi ʻāʻī strep.
- Pyelonephritis: ʻO kēia ka wā e laha ai ka maʻi ʻaʻai mimi i nā puʻupaʻa. Inā hana pinepine ʻia kēia, hiki iā ia ke hana i nā ʻōpala ma nā puʻupaʻa a hōʻeha i ka wā lōʻihi.
He aha nā kumu o ka maʻi puʻupaʻa?
Hiki ke hoʻokaʻawale ʻia nā kumu o ka maʻi puʻupaʻa i ʻelua mau ʻāpana ma muli o ke ʻano o ka hanana ʻana o ka maʻi.
1. Ka hāʻule koke ʻana o ka puʻupaʻa (ʻeha puʻupaʻa koʻikoʻi)
ʻO kēia ka manawa e pau koke ai ka hana a nā puʻupaʻa. ʻO nā kumu nui o kēia:
- Ua emi ke kahe o ke koko i nā puʻupaʻa.
- Ka hōʻino pololei ʻana i nā puʻupaʻa.
- Ka paʻa ʻana o nā puʻupaʻa me ka ʻole o ka puka ʻana o ka mimi.
Eia nā kūlana kahi e hiki ai i nā mea e like me kēia ke hana:
- He ulia nui i hopena i ke kahe koko nui.
- Ka maloʻo nui ʻana o ke kino.
- Ke komo nei ke kino i ka haʻalulu ma muli o kahi maʻi koʻikoʻi (Sepsis).
- Ka ālai ʻana o ke ala mimi ma muli o nā pōhaku mimi a i ʻole ka hoʻonui ʻia ʻana o ka prostate gland.
- Ka ʻike ʻia ʻana i kekahi mau lāʻau lapaʻau a me nā kemika ʻawahia.
- Nā pilikia i ka wā hāpai.
2. Maʻi puʻupaʻa mau loa
Ke hana pono ʻole nā puʻupaʻa no nā mahina ʻekolu a ʻoi, kapa nā kauka iā ia he Maʻi Puʻupaʻa Mau (CKD). ʻElua mau kumu nui no kēia.
- ʻO ka maʻi diabetes Mellitus: ʻO ka maʻi diabetes i kāohi ʻole ʻia ke kumu o ke kiʻekiʻe o ke kō koko i kahi manawa lōʻihi, kahi e hōʻino ai i nā kīʻaha koko palupalu i loko o nā puʻupaʻa.
- Ke koko kiʻekiʻe: Ke piʻi aʻe ke koko, kau ʻia ke kaomi ma luna o nā kīʻaha koko e lawe ana i ke koko i nā puʻupaʻa, e hōʻino ana iā lākou i ka hala ʻana o ka manawa.
Eia kekahi, ʻo ka hoʻohana lōʻihi ʻana i kekahi mau lāʻau ʻeha (ʻoi aku hoʻi nā NSAID e like me ka ibuprofen), ka ʻike ʻana i kekahi mau kemika ʻawahia, a me kekahi mau kūlana hānau hiki ke hana i ka CKD.
ʻO ka pilina ma waena o ka waiʻona a me nā puʻupaʻa
Hoʻokau ka waiʻona i kahi kaumaha hou aʻe ma luna o nā puʻupaʻa, ʻoiai ʻo kā lākou hana ke kānana i nā mea ʻawahia e komo i loko o ke kino. Ke inu ʻoe i ka waiʻona, pono kou mau puʻupaʻa e hana ikaika ma mua o ka maʻamau.
Hiki i ka inu nui ʻana ke alakaʻi i ka hāʻule koke ʻana o nā puʻupaʻa. Eia kekahi, ʻo ka inu nui ʻana i ka waiʻona i kēlā me kēia lā hiki ke hoʻoulu i ke koko kiʻekiʻe, kahi e hiki ai ke alakaʻi i ka maʻi puʻupaʻa no ka manawa lōʻihi.
He aha nā hōʻailona o ka maʻi puʻupaʻa?
E like me kā mākou i ʻōlelo ai ma mua, ʻo nā puʻupaʻa he ʻōkana hiki ke noho asymptomatic a hiki i ka wā e loaʻa ai ka pōʻino nui. No laila,I nā hihia he nui, ʻaʻohe paha he mau hōʻailona i nā pae mua. I ka holomua ʻana o ka maʻi, nā hōʻailona e like me:
- Hoʻonui ʻia ke koko.
- Ka luaʻi a me ka luaʻi.
- ʻAʻohe ʻono o ka meaʻai.
- He ʻono metala i loko o ka waha.
- Ka luhi pinepine a me ka nāwaliwali.
- Paʻakikī i ka noʻonoʻo ʻana.
- Nā pilikia hiamoe.
- ʻŌwiliwili a me ka ʻeha nā ʻiʻo.
- Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae.
- Ka ʻili mau ʻana.
- ʻEha umauma (ma muli o ka hōʻiliʻili ʻana o ka wai a puni ka puʻuwai).
- Ka paʻakikī o ka hanu ʻana (ma muli o ka hōʻiliʻili ʻana o ka wai i loko o nā māmā).
Pehea ʻoe e ʻike ai inā he maʻi puʻupaʻa kou?
E nīnau mua kāu kauka e pili ana i kou mōʻaukala olakino ʻohana, nā lāʻau lapaʻau āu e lawe ai, a inā he mau loli i kāu mau ʻano mimi. A laila e hana ʻo ia i kahi hoʻokolokolo kino. Eia kekahi, hiki ke hana ʻia nā hoʻokolohua aʻe:
- Nā hoʻāʻo koko: E nānā i ka nui o nā huahana ʻōpala (e like me ka urea a me ka creatinine) i loko o ke koko.
- Nā hoʻāʻo mimi: E nānā i nā mea e like me ka protein i loko o ka mimi e ʻike ai inā he hōʻino ʻia nā puʻupaʻa.
- Nā Hoʻāʻo Kiʻi: Hiki i ke kauka ke nānā i ke kūlana o nā puʻupaʻa me kahi mea e like me ke kiʻi ultrasound.
- Biopsy Kidney: ʻO kēia ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupaʻa a hoʻouna iā ia i kahi keʻena hoʻokolohua e hoʻoholo ai i ke kumu pololei o ka maʻi.
He aha nā lāʻau lapaʻau no ka maʻi puʻupaʻa?
Hiki ke ho'ōla ʻia kekahi mau maʻi puʻupaʻa. Eia nō naʻe, ʻaʻole hiki ke ho'ōla loa ʻia ka CKD a mākou e kamaʻilio pinepine ai, ʻo ia hoʻi ka maʻi puʻupaʻa mau loa. Eia nō naʻe, me ka mālama pono ʻana, hiki ke kāohi ʻia ka maʻi a hiki ke kōkua ʻia nā puʻupaʻa e hana lōʻihi.
Hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi nephrologist i kou wā e mālama ai.
1. Nā lāʻau lapaʻau
- Nā lāʻau lapaʻau koko: Hiki i ke koko kiʻekiʻe ke hoʻoulu i ka maʻi puʻupaʻa, a hiki i ka maʻi puʻupaʻa ke hoʻoulu i ke koko kiʻekiʻe. Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me nā ACE inhibitors a i ʻole ARBs. Hiki i kēia mau mea ke kōkua i ka hoʻomalu ʻana i kou koko a hoʻemi i ka nui o ka protein i loko o kāu mimi.
- Nā lāʻau lapaʻau maʻi diabetes: Ua ʻike ʻia kekahi mau lāʻau lapaʻau maʻi diabetes hou, e like me dapagliflozin (Farxiga), e hoʻolohi i ka holomua o ka maʻi puʻupaʻa, ʻoiai i ka poʻe me ka ʻole o ka maʻi diabetes.
- Lāʻau lapaʻau no ka anemia: Ke emi ka hormone erythropoietin i hana ʻia e nā puʻupaʻa, e nalowale ke koko (anemia). Aia kekahi mau lāʻau lapaʻau e mālama ai i kēia.
Nā mea e pale aku ai: Inā he maʻi puʻupaʻa kou, mai lawe i kekahi lāʻau lapaʻau, ʻoiai nā mea hoʻomaha ʻeha, me ke kūkākūkā ʻole me kāu kauka.Hiki i nā lāʻau ʻeha NSAID, ʻoiai ʻo ibuprofen a me naproxen, ke hōʻino i nā puʻupaʻa. E kamaʻilio me kāu kauka a koho i ka mea kūpono iā ʻoe.
2. ʻAi
E kuhikuhi kāu kauka i kahi papaʻai kūikawā nāu. ʻO ia hoʻi ka papaʻai haʻahaʻa i ka sodium (paʻakai), potassium, phosphate, a me ka protein paha. Ke hōʻino ʻia nā puʻupaʻa, he paʻakikī ke hoʻokuʻu aku i kēia mau meaola. ʻO ka pahuhopu o ka papaʻai, ʻo ia ka hoʻēmi ʻana i ke kaumaha ma luna o nā puʻupaʻa. No kēia, he mea nui loa ke ʻimi i ka ʻōlelo aʻo a kahi meaʻai renal, he loea i nā maʻi puʻupaʻa.
3. Dialysis
Ke pau ka hana ʻana o nā puʻupaʻa, pono lākou i ke kōkua o kahi mīkini e hana i kā lākou hana. Ua kapa ʻia kēia he dialysis.
- Hemodialysis: Pili kēia i kahi mīkini e lawe ana i kekahi o kou koko, hoʻomaʻemaʻe iā ia, a hoʻihoʻi iā ia i kou kino.
- ʻO Peritoneal Dialysis: Pili kēia i ka hoʻohana ʻana i ka uhi o ka lua ʻōpū (membrane peritoneal) e hoʻomaʻemaʻe i ke koko.
Aia nā pono a me nā pōʻino i nā ʻano hana ʻelua. E wehewehe kāu kauka i ke ʻano hana kūpono loa iā ʻoe.
4. Hoʻololi ʻana i nā puʻupaʻa
ʻO kēia ke koho lapaʻau maikaʻi loa ke holomua ka maʻi. Hoʻoili ʻia kahi puʻupaʻa kūpono mai kahi kanaka olakino (e ola ana a make paha) ma ke ʻoki kino. Ma hope o ka hoʻoili kūleʻa ʻana, ʻaʻole pono hou ka dialysis. Eia nō naʻe, pono ʻoe e lawe i ka lāʻau lapaʻau no ke koena o kou ola e pale aku i kou kino mai ka hōʻole ʻana i ka puʻupaʻa hou.
Leka Lawe-Home
- He maʻi leo ʻole ka maʻi puʻupaʻa e hōʻike pinepine ʻole ana i nā hōʻailona i nā pae mua .
- ʻO ka maʻi diabetes a me ke koko kiʻekiʻe nā kumu nui o ka maʻi puʻupaʻa. Inā loaʻa iā ʻoe kēia mau kūlana, e hoʻomalu iā lākou.
- Inā ʻoe i loko o kahi hui pilikia, e ʻike pinepine i kāu kauka a e hana i nā hoʻāʻo koko a me ka mimi e pono ai.
- Mai hoʻomau i ka hoʻohana ʻana i nā lāʻau ʻeha, ʻoi aku hoʻi nā NSAID, me ka ʻole o ke aʻo ʻana mai ke kauka.
- Inā ua ʻike ʻia ʻoe he maʻi puʻupaʻa, mai hopohopo a e hahai pono i nā ʻōlelo a kāu kauka. Hiki i kēia ke kōkua i ka kaohi ʻana i ka holomua o ka maʻi.
Maʻi Pūpū, Ka Holo ʻole ʻana o ka Pūpū, CKD, Dialysis, Hoʻoili Pūpū, Maʻi Diabetes a me nā Pūpū
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