Ua haʻi aku ke kauka iā ʻoe he pilikia kou i ka puʻupaʻa a i ʻole ka nāwaliwali? A i ʻole ua lohe ʻoe ua loaʻa i kekahi āu i ʻike ai ka maʻi puʻupaʻa? He mea maʻamau loa ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kēia mau ʻōlelo. Akā inā ʻike mākou i kēia, hiki ke hoʻemi nui ʻia kēlā makaʻu. No laila, i kēia lā, e kamaʻilio kākou e pili ana i kēia maʻi puʻupaʻa lōʻihi, ʻo ia hoʻi, ʻo ka 'Chronic Kidney Disease (CKD)', he aha kona mau pae like ʻole, a me nā mea a mākou e hana ai i kēlā me kēia pae.
No ke aha i māhele ʻia ai ka maʻi puʻupaʻa (CKD) i nā pae?
I ka ʻōlelo maʻalahi, ʻo CKD kahi kūlana kahi e emi mālie ai ka hana o nā puʻupaʻa i ka hala ʻana o ka manawa. ʻAʻole kēia e hana koke ʻia. ʻO ia ke kumu e hoʻokaʻawale ai nā kauka i ka maʻi i nā pae 1 a 5 e hoʻomaopopo ai i kona koʻikoʻi.
E noʻonoʻo e like me ke alapiʻi. Ke noho ʻoe ma luna o ke alapiʻi, hana maikaʻi loa kou mau puʻupaʻa. I kou iho ʻana i lalo, emi iho kā lākou hana.
- Nā pae mua (nā pae 1-3): I loko o kēia mau pae, ke hana maikaʻi nei kou mau puʻupaʻa a i ʻole ma kahi pae maʻamau . I ka hapa nui o nā hihia, ʻaʻohe hōʻailona nui i kēia pae.
- Nā pae hope (nā pae 4-5): I kēia pae, ua emi nui ka hana a nā puʻupaʻa. I ka pae hope loa, aneane pau loa paha ka hana pono ʻole o nā puʻupaʻa.
Akā, ʻaʻole kēia manaʻo e holomua ka maʻi puʻupaʻa o kēlā me kēia kanaka i ke kahua 5. Me ka mālama pono ʻana a me nā loli o ke ʻano o ka nohona, hiki i nā poʻe he nui ke kaohi i ka maʻi ma kona pae o kēia manawa a hoʻopaneʻe i kona holomua no ka manawa lōʻihi.
Pehea e hoʻoholo ʻia ai kēia mau pae? He aha ka GFR?
ʻAe, e nānā kākou pehea e hiki ai i ke kauka ke haʻi pololei i ke kahua āu e noho nei. Hoʻoholo nui ʻia kēia ma ka nānā ʻana i ka "filtration rate" o kou mau puʻupaʻa.
Ua like nā puʻupaʻa ʻelua i loko o ko kākou kino me nā kānana wai ʻelua. ʻO ka hana nui o nā puʻupaʻa, ʻo ia ke kānana a hoʻomaʻemaʻe i nā huahana ʻōpala i makemake ʻole ʻia, ka wai keu a me nā paʻakai mai ke koko a hoʻokuʻu iā lākou ma ke ʻano he mimi. He miliona mau ʻāpana liʻiliʻi loa i loko o nā puʻupaʻa e hana ana i kēia kaʻina kānana. Kāhea mākou iā lākou he `(nephrons)`. ʻO ke kānana nui i loko o kēlā me kēia nephrons ua kapa ʻia ʻo `(glomerulus)`.
ʻO ke ana ʻana o ka wikiwiki o ka hoʻomaʻemaʻe ʻia ʻana o kou koko ma o kēia mau kānana ua kapa ʻia ʻo Glomerular Filtration Rate , a i ʻole GFR .
Ke hōʻino ʻia nā puʻupaʻa, emi iho kēia helu kānana (GFR). No ka mea he paʻakikī ke ana pololei i kēia GFR, ana nā kauka i ka nui o kahi huahana ʻōpala i kapa ʻia ʻo "creatinine" i loko o kou koko a laila hoʻohana iā ia e helu i kāu GFR me ka hoʻohana ʻana i kahi hoʻohālikelike kūikawā, e like me kou makahiki a me ke kāne. Kāhea mākou i kēia he GFR i manaʻo ʻia , a i ʻole eGFR.ʻO kēia ka waiwai i helu ʻia ʻo eGFR ma kāu hōʻike koko.
Eia kekahi, hana ʻia kahi hoʻāʻo mimi e nānā i ka protein (albumin) i loko o ka mimi. I kekahi manawa, ʻoiai inā maʻamau ka eGFR, hiki i ka protein i loko o ka mimi ke lilo i hōʻailona mua o ka hōʻino ʻia o nā puʻupaʻa.
Nā pae CKD a me ko lākou manaʻo
ʻO kēia ka waiwai eGFR i hoʻohana ʻia e hoʻokaʻawale i nā pae 5 o CKD. Hiki iā ʻoe ke hoʻomaopopo maʻalahi iā ia ma ka nānā ʻana i kēia papa.
| Kahua | ka waiwai eGFR (mL/min) | Ke kūlana o ka puʻupaʻa |
|---|---|---|
| Pae 1 | 90 a ʻoi aku paha | Aia kahi pōʻino iki i nā puʻupaʻa, akā ua maʻamau ka nui o ka kānana. |
| Pae 2 | 60 - 89 | Aia kahi pōʻino iki i nā puʻupaʻa a me kahi emi iki o ka helu kānana. |
| Pae 3a | 45 - 59 | Aia kahi hōʻino iki i nā puʻupaʻa a me ka emi nui ʻana o ka helu kānana. |
| Pae 3b | 30 - 44 | Ka hōʻino iki ʻana i nā puʻupaʻa a me ka hoʻemi hou ʻana i ka helu kānana. |
| Pae 4 | 15 - 29 | Ua hōʻino nui ʻia nā puʻupaʻa. Haʻahaʻa loa ka helu kānana. |
| Pae 5 | Ma lalo o 15 | Ka hāʻule ʻana o nā puʻupaʻa. I kēia manawa, pono ka dialysis a i ʻole ka hoʻoili puʻupaʻa. |
He aha nā hōʻailona e ʻike ʻia ma kēlā me kēia pae?
ʻO kekahi o nā hiʻohiʻona kūikawā o CKD ʻo ia ka ʻokoʻa o nā hōʻailona ma muli o ke kahua.
Nā Pae 1 a me 2
I kēia mau pae mua, ʻaʻohe hōʻailona o ka hapa nui o ka poʻe no ka mea ke hana maikaʻi nei ko lākou mau puʻupaʻa. ʻIke pinepine ʻia ia i ka wā e hana ʻia ai nā hoʻāʻo koko a mimi paha no kekahi kūlana ʻē aʻe, a i ʻole ke nānā ʻia ke koko. Akā, e ʻike paha kekahi poʻe i nā mea e like me:
- Ka pehu ʻana o nā lima, nā wāwae, a i ʻole nā kuʻekuʻe wāwae
- Nā maʻi ʻōpū mimi pinepine
- Mimi huʻa
Nā Pae 3a a me 3b
I ka emi ʻana o ka hana o nā puʻupaʻa, ʻoi aku ka paʻakikī o ke kino e hoʻomaʻamaʻa iā ia. ʻO kēia ka manawa e hoʻomaka ai ka nui o ka poʻe e ʻike i nā hōʻailona.
- Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae
- ʻO ka pohō kaumaha a me ka nalowale o ka makemake
- Manaʻo luhi a make ke ola
- ʻEhaʻeha o nā ʻiʻo
- Paʻakikī ka hanu ʻana
- ʻAʻole hiki ke hiamoe
- ʻIli ʻāʻī
- Pono pinepine e mimi, ʻoi aku hoʻi i ka pō
- Mimi huʻa a ʻeleʻele paha
Nā Pae 4 a me 5
I kēia manawa, ʻaʻole e hana pono nā puʻupaʻa, a hoʻomaka nā huahana ʻōpala mai ke kino e hōʻiliʻili i loko o ke koko. Hiki i kēia ke alakaʻi i nā pilikia koʻikoʻi. Ma waho aʻe o nā hōʻailona i ʻōlelo ʻia ma luna, hiki ke loaʻa pū kekahi mau mea:
- Paʻakikī i ka noʻonoʻo ʻana
- ʻEha poʻo
- ʻEha ʻōpū haʻahaʻa
- ʻO ke kani ʻana ma nā lima a me nā wāwae
- Ka luaʻi a me ka luaʻi
- Ka emi ʻana a i ʻole ka pau ʻana o ka mimi ʻana
- Hanu ʻino
- Ka hoʻololi ʻana o ka ʻili (huli i ka hina a i ʻole ka melemele)
He aha nā lāʻau lapaʻau no ka maʻi puʻupaʻa?
ʻAʻohe lāʻau lapaʻau no CKD i kēia manawa. Eia nō naʻe, hiki i ka lāʻau lapaʻau ke kāohi i nā hōʻailona a hoʻolohi i ka holomua o ka maʻi. ʻOkoʻa nā koho lapaʻau ma muli o ke kahua o ka maʻi.
Lapaʻau no nā pae 1 a me 2
ʻO ka pahuhopu nui i kēia manawa, ʻo ia ke pale aku i ka hōʻino hou ʻana i nā puʻupaʻa. Hiki i kāu kauka ke ʻōlelo i kēia mau mea:
- Inā ʻoe e puhipaka ana, e hoʻōki koke.
- ʻAi ʻana i ka meaʻai olakino, haʻahaʻa i ka paʻakai a me ka ʻaila.
- Hoʻoikaika kino mau.
- Ke kāohi nei i ke kaumaha o ke kino.
- Inā loaʻa iā ʻoe ka maʻi diabetes, e kaohi pono i kou pae kō koko.
- Inā he koko kiʻekiʻe kou, e kaohi iā ia.
Lapaʻau no nā pae 3a a me 3b
I kēia pae, me nā loli o ke ʻano o ka nohona, pono paha nā lāʻau lapaʻau e kaohi i ka maʻi.
- Nā lāʻau lapaʻau no ke koko kiʻekiʻe: ʻOiai inā ʻaʻohe ou koko kiʻekiʻe, hiki i kekahi mau lāʻau lapaʻau ke hōʻemi i ka hōʻino ʻana i kou mau puʻupaʻa.
- Lāʻau hoʻohaʻahaʻa kolesterol.
- Nā lāʻau lapaʻau maʻi diabetes: Hāʻawi ʻia kekahi mau lāʻau lapaʻau, ʻoiai nā mea hoʻopaʻa SGLT2, e pale i nā puʻupaʻa ʻoiai i ka poʻe me ka ʻole o ka maʻi diabetes.
- Diuretics: Kōkua i ka wehe ʻana i ka paʻakai a me ka wai keu mai ke kino.
- Nā lāʻau lapaʻau ʻē aʻe: Nā papa hao a i ʻole nā huaora ʻē aʻe e hoʻoikaika i nā iwi a pale i ka anemia.
Lapaʻau no nā pae 4 a me 5
Ke kokoke nā puʻupaʻa i ka hāʻule ʻana, ʻaʻole lawa ka lāʻau lapaʻau wale nō e mālama i ke kino i ke olakino. ʻO nā koho lapaʻau nui ʻelua i kēia pae:
- Dialysis: He mīkini e wehe i ke koko mai kou mau puʻupaʻa.
- Hoʻoili Puʻupaʻa: Ke hoʻoili ʻoki kino ʻana o kahi puʻupaʻa olakino i loko o ke kino.
Hoʻoholo ʻia kēia mau lāʻau lapaʻau a pau e kāu kauka ma hope o ka nānā pono ʻana i kou olakino. No laila , he mea nui loa e kūkākūkā pinepine me kāu kauka a hahai i kā lākou ʻōlelo aʻo.
Leka Lawe-Home
- He maʻi ʻo CKD e hoʻonāwaliwali mālie ai i ka hana o nā puʻupaʻa i ka hala ʻana o ka manawa.
- Ua hoʻokaʻawale ʻia ka maʻi i nā pae 1 a 5 ma muli o ke koʻikoʻi, a hoʻohana ʻia kahi ana i kapa ʻia ʻo eGFR no kēia.
- I nā pae mua, ʻaʻohe pinepine nā hōʻailona. No laila, inā he mau mea pilikia kou e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, he mea nui loa ia e hana i nā nānā lapaʻau maʻamau.
- ʻOiai ʻaʻole hiki ke ho'ōla loa ʻia ʻo CKD, hiki ke kāohi ʻia ka ʻino ʻana o ka maʻi me ka mālama kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona.
- E kamaʻilio mau me kāu kauka e pili ana i kou kūlana, ke kahua, a me ka lāʻau lapaʻau.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo