Ngā mea me mōhio koe mō te ngoikore o te whatukuhu!

Kua whakaaro kē koe ki te nui o te mahi a ēnei whatukuhu iti e rua i roto i tō tātou tinana? I ētahi wā, ka ngoikore ēnei whatukuhu. Ina tupu tēnā, ka kiia e mātou ko te ngoikore o te whatukuhu. Ahakoa he kaupapa whakamataku tēnei mō ētahi, he mea nui kia mōhio ki tēnei.

He aha te ngoikore o te whatukuhu?

He māmā noa iho, ko te ngoikore o te whatukuhu he āhuatanga e kore ai tetahi, e rua rānei o ō whatukuhu e mahi tika. Ko te tikanga, kāore e taea e rātou te mahi i tā rātou mahi takitahi. E rua ngā huarahi e puta ai tēnei. Ko te tuatahi ko te ngoikore o te whatukuhu ohorere . He āhuatanga tēnei e puta ohorere mai ana. Engari i ētahi wā he wā poto noa iho, ā, ka taea te rongoā. Ko tētahi atu momo ko te ngoikore o te whatukuhu mau tonu . He hekenga āta haere, he puhoi hoki tēnei o ngā whatukuhu i roto i te wā. Koinei te āhuatanga tino noa mō te nuinga o te tangata.

Ka taea e tēnei āhua o te ngoikore o te whatukuhu te haere mārire ki te wāhanga whakamutunga, arā, ko te Mate Whatukuhu Wāhanga Mutunga (ESKD) . Inaa, ki te kore e rongoatia, ka taea e te ESKD te whakararu i te ora. Ka taea e te tangata whai mate pēnei te ora mō ētahi rā, wiki rānei me te kore maimoatanga. Engari kaua e manukanuka, mā te maimoatanga tika, ka taea te whakahaere i te ngoikore o te whatukuhu, ā, ka pai te kounga o te oranga.

He aha te mea ka pā ki ō tātou whatukuhu?

Nā, kia tirohia tātou he aha te mahi a ēnei okana e kiia nei ko ngā whatukuhu ki ō tātou tinana. He rite ō whatukuhu ki ngā pīni e rua. He rite te rahi ki tō ringa. E mōhio ana koe kei hea rātou? Kei raro noa iho i tō rara, ki te taha o muri. E rua ngā whatukuhu o te nuinga o te tangata e mahi pai ana. Engari ki te mahi pai te whatukuhu kotahi, ka taea e koe te noho humarie.

Ko te mahi matua a ngā whatukuhu he tango i ngā paitini mai i ō tātou tinana . Whakaarohia rātou he tātari. Ka tātarihia e rātou ō toto, ā, ka tangohia ngā para kāore e hiahiatia ana hei mimi (e kiia ana hoki e tātou he mimi ).

Whakaarohia, he aha te mea ka puta mēnā kāore ēnei whatukuhu e mahi tika? Ka puranga aua para i roto i te tinana. Ina tupu tēnā, ka tīmata koe ki te māuiui, ā, ki te kore e rongoatia, ka mate pea koe i te mutunga. Engari, e ai ki taku kōrero i mua, ka taea e te nuinga o te tangata te whakahaere i tēnei mate mā te maimoatanga tika.

He pēhea te noa o te ngoikore o te whatukuhu?

Kia tirohia te whānui o te mate nei, arā, te ngoikore o te whatukuhu. I tētahi whenua pērā i Amerika, e 7.5 mano tāra te tangata e pāngia ana e tēnei mate i ia tau. Ki te titiro koe ki te ao katoa, e 2 miriona te tangata e pāngia ana e tēnei mate. He tokomaha hoki ngā tāngata e pāngia ana e tēnei mate i tō tātou whenua, inā koa he mea noa ngā mate pērā i te mate huka me te toto toto tiketike.

He aha ngā wāhanga e rima o te mate tākihi?

Ina kōrero tātou mō ngā wāhanga o te mate tākihi, ka titiro tātou ki tō eGFR (Estimated Glomerular Filtration Rate).Kua karangatia te uara. He whakamātautau toto tēnei.

Ki te kī māmā noa, he ine te eGFR i te pai o te tātari a ō whatukuhu i ngā mea. Ko te eGFR o te tangata hauora he nui ake i te 90. Ko te eGFR o te 0 te tikanga kāore ngā whatukuhu e mahi ana.

E rima ngā wāhanga matua o te mate whatukuhu:

• Wāhanga I: Kei runga ake i te 90 tō GFR. I tēnei wā, kei te mahi pai ō whatukuhu, ahakoa he iti noa ngā pakaru.
• Wāhanga II: Tērā pea kei waenganui i te 60 me te 89 tō GFR. He nui ake te pakaru o ō whatukuhu i tō te wāhanga I, engari kei te pai tonu te mahi.
• Wāhanga III: Tērā pea kei waenga i te 30 me te 59 tō GFR. I tēnei wāhanga, tērā pea he ngawari, he kino rānei te mahi a te whatukuhu.
• Wāhanga IV: Tērā pea kei waenga i te 15 me te 29 tō GFR. Koinei te wā ka tino heke te mahi a te whatukuhu.
• Wāhanga V: Kei raro iho i te 15 tō GFR. Ko te tikanga kua tata ō whatukuhu ki te ngoikore, kua kore rānei e mahi. Koinei te wā ka tīmata te puta o ngā tohu.

He aha ngā tohu whakatūpato wawe o te ngoikore o te whatukuhu?

He maha ngā wā, kāore he tohu o te mate tākihi i te tīmatanga, he tohu ngawari noa iho rānei. Ahakoa kāore koe e kite i tetahi mea, ka taea e te mate tākihi mau tonu (CKD) te whakararu i a koe mai i roto.

Ka rerekē ngā tohu o te ngoikore o te whatukuhu i ia tangata, i ia tangata. Mena kāore ō whatukuhu e mahi tika ana, tirohia tētahi, ētahi rānei o ēnei tohu:

• Te tino ngenge (te ngenge). Ehara i te ngenge noa iho, engari he ngenge e kore e memeha ahakoa te roa o te moe.
• Whakapairuaki me te ruaki. Tērā pea ka ngaro te hiahia kai i tēnei.
• Te pōhēhē, te uaua rānei ki te arotahi. Whakaarohia te āhua pōuri, te kore e taea te arotahi ki tētahi mea.
• Pupuhi (edema). Pupuhi, inā koa i te taha o ngā ringaringa, o ngā pona waewae, o te mata rānei. E ai ki ētahi tāngata he pupuhi kei te taha o ō rātou kanohi ina ara ake i te ata.
• He panonitanga o te auau o tō mimi. Tērā pea me mimi pinepine koe, ka heke rānei te nui o te mimi e tukuna ana e koe. Tērā pea he mimi huka tōu.
• Ngā uaua e māuiui ana, e totitoti ana rānei.
• Kiri maroke, kiri mākūkū rānei.
• Te ngaronga o te hiahia kai, te reka whakarewa rānei i roto i te waha.

Kaua e manukanuka mēnā kei a koe tētahi, e rua rānei o ēnei tohu, engari ki te mau tonu, me toro atu koe ki te tākuta .

He aha ngā tino take o te ngoikore o te whatukuhu?

Ko te mate huka me te toto toto tiketike ngā tino take o te mate whatukuhu mau tonu me te ngoikore o te whatukuhu. He mate tino noa ēnei e rua i tō tātou whenua.

Ki te mea he mate huka tōu, ki te kore e pai te whakahaere, ka teitei tonu te taumata o te huka i roto i tō toto (hyperglycemia). Ki te noho teitei tonu te taumata o te huka i roto i tō toto, ka kino pea ō whatukuhu me ētahi atu okana.

Ko te toto toto tiketike te tikanga he nui rawa te kaha o te rere o te toto i roto i ngā oko toto. Mēnā ka roa te wā e kore e rongoatia, ka taea e tēnei kaha tāpiri te kino i ngā kiko o ngā whatukuhu.

Ehara te ngoikore o te whatukuhu i te mea ka puta ohorere mai. Tērā atu anō ngā āhuatanga ka pā ki tēnei:

• Mate Tākihi Polycystic (PKD): He mate ira tēnei i tukuna iho mai i tētahi o ngā mātua. I roto i tēnei, ka puta he pūkahukahu kī tonu i te wai i roto i ngā tākihi.
• Ngā mate o te glomerulus: Ka pāngia e ēnei mate te kaha o ngā whatukuhu ki te tātari i ngā para.
• Ngā mate tākihi ārai mate: Hei tauira, he mate e kiia nei ko te lupus . He mate ārai mate tēnei, arā, ka whakaeke te pūnaha ārai mate o te tinana i ōna ake pūtau. Ka pāngia pea ngā okana e tēnei, ka mamae ngā hononga, ka pāngia te kirika, ka whara te kiri.

I ētahi wā, ka puta ohorere te ngoikore o te whatukuhu mō tētahi take kāore i te tūmanakohia. Ka kiia tēnei ko te Whara Whatukuhu Āwhata . I tēnei wā, ka ngaro ohorere te kaha o ngā whatukuhu ki te mahi. Ka puta pea tēnei āhuatanga i roto i ētahi rā. Engari i te nuinga o te wā, he wā poto noa iho.

Ko ngā tino take o te ngoikore ohorere o te whatukuhu ko:

• Ka taea e ētahi rongoā, inā koa ko ētahi rongoā whakamamae mamae, te take o tēnei.
• Te matewai nui. Ina kore e ranea te wai o te tinana.
• Te aukati i te ara mimi. Tērā pea ka puta tēnei i tētahi mea pērā i te kōhatu mimi.
• Ngā mate pūnaha kāore i rongoatia. Hei tauira, te mate manawa, te mate ate rānei.

He aha ngā āhuatanga mōrearea mō te ngoikore o te whatukuhu?

Ka pāngia te tangata katoa e te ngoikore o te whatukuhu. Heoi, tera pea ka nui ake tō mōrearea mēnā kei a koe tētahi o ēnei āhuatanga e whai ake nei:

• Mena he mate huka tōu .
• Mena he toto toto tiketike tōu (hypertension) .
• Mena he mate ngakau tōu .
• Mena kua pāngia tetahi o tō whānau e te mate tākihi (he mate tuku iho).
• Mena he rerekētanga hanganga ōu i roto i ō whatukuhu .
• Mena he mangu koe (nā ētahi take ira).
• Mena kua neke atu i te 60 tau tō pakeke .
• Mena kua roa koe e tango ana i ngā rongoā whakamamae mamae , inā koa ko ngā NSAID (Nonsteroidal Anti-inflammatory Drugs) ka taea te hoko mai i te whare rongoā.

He aha ngā raruraru o te ngoikore o te whatukuhu?

He maha ngā mahi a ngā whatukuhu i roto i te tinana. Nō reira, ina ngoikore ngā whatukuhu, ka puta he maha ngā raruraru. Hei tauira:

• Te toto toto tiketike.
• Te mate toto kore toto. Ko te tikanga o tēnā he kore toto. Ka whakaputahia e ngā whatukuhu he homoni e āwhina ana ki te hanga i ngā toto whero. Ina pakaru ngā whatukuhu, ka heke iho.
• Te mate wheua.
• He wai e karapoti ana i ōu pukahukahu.
• Te pakaru o te io.
• Te kore taurite o te irahiko. Ko te tikanga tēnei he panoni i te nui o ngā tote pēnei i te konutai me te pāhare pāporo i roto i te toto.

Kaua e whakaaro ka mate koe nā te mea kua kitea he ngoikore tō whatukuhu. Ki te whai koe i te mahere maimoatanga a tō tākuta—tae atu ki ngā rongoā, ngā huringa momo noho, me te whakaiti i te tote me ētahi kai—ka taea e koe te whakahaere pai i tō āhua. Heoi, ki te kore koe e whakarongo ki tō tākuta, ka kino haere ō whatukuhu, ā, ka mate pea koe.

Ka taea e te ngoikore o te whatukuhu te mate?

Ae, ka mate pea te mate whatukuhu o te wāhanga whakamutunga (ESKD) . Engari e ai ki taku kōrero i mua, ki te tika te maimoatanga, ka taea e te nuinga o te tangata te ora me te ngoikore o te whatukuhu. Ko te mea nui kia maumahara ko te kore he rongoā mō te ngoikore o te whatukuhu. Ko te tikanga ahakoa te maimoatanga, kāore ō whatukuhu e mahi pērā i mua i te whanaketanga o te mate. Ko te whāinga o te maimoatanga he tiaki i te mahi e toe ana o ō whatukuhu mō te roa rawa atu, me te whakaroa i tōna tere pirau.

Me pēhea te tātaritanga o te ngoikore o te whatukuhu?

Tērā pea ka whakamahia e te tākuta ngā momo whakamātautau mahi whatukuhu hei tirotiro i te mahi a ō whatukuhu, hei kimi hoki mēnā kei te ngoikore tō whatukuhu. Mēnā kei te whakapae tō tākuta kei te mōrearea koe ki te ngoikore o tō whatukuhu, koinei ngā whakamātautau e mahia ana i te nuinga o te wā:

• Ngā whakamātautau toto: Ka tirohia e ēnei te pai o te tango a ō whatukuhu i ngā para mai i ō toto. Ka tangohia e te tākuta tētahi tauira toto iti mai i tētahi uaua i tō ringa mā te whakamahi i tētahi ngira angiangi. Kātahi ka whakamatautauria te tauira toto i roto i tētahi taiwhanga. Ka whakamahia hoki tēnei whakamātautau toto hei tirotiro i te uara eGFR i whakahuatia ake nei.
• Ngā whakamātautau mimi: Ka ine ēnei i ētahi mea i roto i tō mimi, pērā i te pūmua, te toto rānei. Me mimi koe ki roto i tētahi ipu motuhake i te tari tākuta, i te hōhipera rānei. Kātahi ka whakamatautauria te tauira mimi i roto i te taiwhanga.
• Ngā whakamātautau whakaahua: Mā ēnei whakamātautau ka taea e te tākuta te tirotiro i ō whatukuhu me te rohe e karapoti ana kia kitea ai mēnā he āhuatanga rerekē, he aukati rānei. Ko ngā whakamātautau whakaahua noa ko te ultrasound whatukuhu , te CT urogram, me te MRI .

Me pēhea te rongoā mō te ngoikore o te whatukuhu?

Ko te maimoatanga mō te ngoikore o te whatukuhu ka whakawhirinaki ki te take me te kaha o te mate. Kāore e taea e ngā tākuta te whakaora katoa i te ngoikore o te whatukuhu, ā, he mate morearea hoki. Engari ka taea e te maimoatanga te āwhina i a koe kia roa ake te ora me te whakahaere i ngā tohu me ngā raruraru.

Mena kei te ngoikore haere ō whatukuhu, ka whakamahia pea e te tākuta ētahi tikanga rerekē hei aroturuki i tō hauora me te pupuri i te mahi a te whatukuhu mō te wā roa rawa atu. Kei roto i ēnei tikanga ko:

• Ngā whakamātautau toto auau.
• Te tirotiro i te toto toto i ia wā.
• Ngā rongoā.

Mena kei te pāngia koe e te ngoikore o te whatukuhu i te wāhanga whakamutunga , me rongoā koe kia ora tonu ai koe. E rua ngā maimoatanga matua mō te ngoikore o te whatukuhu: te dialysis me te whakawhitinga whatukuhu .

Ngā rongoā mō te ngoikore o te whatukuhu

I runga i te pūtake o tō mate whatukuhu, ka tohua pea e te tākuta tētahi, ētahi rānei o ngā rongoā e whai ake nei:

• Ngā aukati whākōkī-hurihuri angiotensin (ACE) me ngā aukati kaiwhiwhi angiotensin II (ARB): Ka āwhina ēnei rongoā ki te whakaheke i tō toto toto.
• Ngā rongoā whakaheke toto: Ka āwhina ēnei ki te tango i te wai nui mai i te tinana. Ka karangatia hoki ēnei e ētahi he 'pire wai'.
• Ngā Statin: Ka āwhina ēnei ki te whakaheke i ō taumata cholesterol.
• Ngā kaihoko whakaohooho Erythropoietin: Ka āwhina ēnei ki te hanga i ngā toto whero mēnā he anemia tōu.
• Huaora D me te Calcitriol: Ka āwhina ēnei ki te aukati i te ngaronga o te wheua.
• Ngā here phosphate: Ka āwhina ēnei ki te tango i te nui rawa o te phosphate mai i ō toto.

Dialysis

He tikanga āwhina te dialysis i tō tinana ki te tātari toto. Whakaarohia he rite ki te whakangāwari i ō whatukuhu kia kore ai e mahi nui. E rua ngā momo dialysis:

• Hemodialysis: He mīhini tēnei e horoi ana i ō toto i ia wā. He maha ngā tāngata e pāngia ana e te ngoikore o ō rātou whatukuhu e haere ana ki te hōhipera, ki te pokapū dialysis rānei, e toru ki te whā rā i te wiki mō te hemodialysis. Tērā pea he mahi hoha tēnei, nā te mea me hono koe ki te mīhini mō ngā hāora maha i ia wā.
• Te tātaritanga peritoneal:I tēnei tikanga, ka whakauruhia e te tākuta he ngongo iti (catheter) ki raro i te kiri o tō puku, ka hono atu ki tētahi putea kei roto te wai dialysis. Ka rere tēnei wai mai i te putea ki roto i te kōhao o tō puku, ka tangohia ngā para me ngā wai tāpiri, ka hoki anō ki te putea. I ētahi wā, ka taea te mahi i te peritoneal dialysis i te kāinga.

Te Whakatōnga Whatukuhu

I roto i te whakawhitinga whatukuhu, ka whakakapia tō whatukuhu kua pakaru e te taote pokanga ki tētahi whatukuhu hauora. Ka taea e tēnei whatukuhu hauora (te okana kaituku) te ahu mai i tētahi kaituku kua mate, i tētahi kaituku ora rānei. Ka taea e koe te ora pai me tētahi whatukuhu hauora. Mena ka whakawhitia tō whatukuhu, me tango rongoā koe mō te toenga o tō oranga hei ārai i te kino o te whatukuhu kua whakawhitia. Ka mahi ēnei rongoā hei aukati i tō tinana kei paopao i te whatukuhu hou.

Ka taea te ora ake i te ngoikore o te whatukuhu i te wāhanga whakamutunga?

He maha ngā āhuatanga e whakawhirinaki ana ki tēnei. Mēnā ka tika te maimoatanga, ka taea e koe te noho harikoa, te oranga whai hua. Heoi anō, me tumanako koe ka hiahiatia he maimoatanga mō te toenga o tō oranga. Kia maumahara, kāore e taea te whakakore i te mate tākihi, te ngoikore rānei o te tākihi , engari me whakaroa noa.

Me pēhea te ārai i te ngoikore o te whatukuhu?

Ahakoa kāore e taea te whakakore i te ngoikore o te whatukuhu me te mate whatukuhu mau tonu (CKD), tera ētahi mea ka taea e koe te mahi hei tiaki i te mahi a tō whatukuhu. Mā ngā tikanga hauora me ngā mahi o ia rā ka taea te whakaroa i te tere o te ngaronga o te mahi a ō whatukuhu.

Mena kei a koe te CKD, te ngoikore rānei o te whatukuhu, he mea pai kia mahia ēnei mea:

• Aroturukihia te mahi a tō whatukuhu i ia wā (me whakamātauria kia rite ki ngā tohutohu a tō tākuta).
• Mena he mate huka tōu, kia mau tonu te taumata huka o tō toto ki roto i te awhe noa .
• Kia mau tonu te taumata o tō toto toto ki roto i te awhe noa .
• Āta karohia te whakamahi i ngā hua tupeka (pērā i te momi hikareti).
• Āta karohia ngā kai he nui te pāhare pāporo me te konutai (tote) . He pai ake te pātai atu ki te tākuta, ki te tohunga kai rānei mō tēnei, nā te mea he nui hoki te pāhare pāporo i roto i ētahi hua me ngā huawhenua.
• Kia mahara ki te haere ki ia wā hui kua whakaritea me tō tākuta.

He aha ngā mea ka taea e koe te tumanako mēnā he ngoikore tō whatukuhu?

Kāore he rongoā katoa mō te ngoikore o te whatukuhu. Heoi, mā te tātaritanga tika me te maimoatanga, ka roa ake tō oranga me te kore e nui ngā panoni ki te kounga o tō oranga.

Āhea koe me toro atu ki te tākuta?

Mena kei a koe ngā āhuatanga mōrearea mō te ngoikore o te whatukuhu, tirohia he tākuta. Ko te tikanga o tēnā:

• Mena he toto toto tiketike tōu .
• Ki te kite koe i ngā panonitanga o tō tauira mimi (mimi pinepine, mimi iti, mimi huka, toto).
• Mena kei te pāngia koe e te kohu roro , e uaua ana rānei ki te arotahi.
• Mena kei te whakapairuaki koe, kei te ruaki rānei .
• Mena he mate huka tōu .
• Mena kua pāngia tetahi o tō whānau e te mate tākihi .
• Mena kua pāngia koe e tētahi raruraru tākihi i mua (hei tauira, te ngoikore ohorere o te tākihi).
• Mena ka tangohia e koe ngā NSAID i ngā wā katoa .

Ki te pā mai tētahi āhuatanga pēnei ki a koe, kaua e warewaretia. He mea whakaaro nui kia tere tonu te toro atu ki te tākuta, kia whiwhi tohutohu ai.

He aha ngā pātai me pātai atu koe ki te tākuta?

Whakaarohia te pātai atu ki tō tākuta i ēnei pātai mō te ngoikore o te whatukuhu:

• Me pēhea koe e mōhio ai he ngoikore tōku whatukuhu?
• Mena kāore he mate whatukuhu kei roto i ahau, he aha atu anō ngā āhuatanga ka pā mai ki ahau?
• He aha te take o te ngoikore o taku whatukuhu?
• Me hiahia ahau ki te dialysis?
• He aha te momo dialysis e taunaki ana koe?
• He pai ahau mō te whakawhitinga whatukuhu?
• He aha ngā momo rongoā e taunaki ana koe māku?
• Me huri taku kai?
• Kia hia ngā wā me haere mai ahau ki te rongoā?

Āhea me whakaarohia te manaaki hōhipera mēnā he ngoikore te whatukuhu?

He whakatau whaiaro te whakatau āhea te wā e whiwhi ai koe, tō hoa aroha rānei i te tiaki hōhipera . Ka taea e tō tīma hauora te āwhina i a koe ki te whakatau ko tēhea te mea pai mō tō āhuatanga. Ko te whāinga o te tiaki hōhipera he whakarato whakamarie me te tautoko mō te hunga e pāngia ana e te mate mutunga, pērā i te ngoikore o te whatukuhu. I roto i te take o te ngoikore o te whatukuhu, ka puta te tiaki hōhipera ina kore e whai hua, e kore rānei e taea te mahi i ngā maimoatanga pērā i te dialysis, te whakawhitinga whatukuhu rānei.

Nā, he aha ngā mea hei maumahara mā tātou i ēnei mea katoa?

He mea nui ngā whatukuhu i roto i tō tātou tinana. Ka tangohia e rātou ngā para me ngā wai tāpiri. Ki te kore e pai te mahi a ō whatukuhu, ko te tikanga kāore e mahi tika ana. Ki te kore e rongoatia, ka mate pea koe. Kaua e manukanuka, mā te dialysis , te whakawhitinga whatukuhu rānei koe e āwhina ki te noho pai tonu. Tērā pea kei roto i tō mahere maimoatanga te tango rongoā me te whai i tētahi kai motuhake. Kia mau ki ō whakaritenga katoa me tō tākuta. Mena he pātai, he āwangawanga rānei āu mō tō maimoatanga, ngā rongoā, ngā huringa momo noho, me tētahi atu mea rānei i roto i tō mahere maimoatanga, kōrero ki tō tākuta.

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` Te ngoikore o te whatukuhu, te mate whatukuhu, te mate huka, te toto toto tiketike, te dialysis, te whakawhitinga whatukuhu