Kei te pupuhi ō waewae? Kei te huka tō mimi? Tērā pea he Membranous Nephropathy (MN) tēnei.

Kua kite koe i te pupuhi haere o ō waewae me ō pona waewae? Kua kite rānei koe he huka te mimi? Ehara ēnei i te tohu hei wareware noa. He tohu pea ēnei kei te hē tetahi mea i roto i ō whatukuhu. I tēnei rā ka kōrero tātou mō tētahi mate onge engari he mea nui e pā ana ki ō whatukuhu. Ko te ingoa o tēnā ko te Membranous Nephropathy (MN).

He aha te Nephropathy Membranous (MN)?

Ki te whakarapopoto, ko te Membranous Nephropathy (MN) he āhua e whakaekehia ai ō ake whatukuhu e tō pūnaha ārai mate, te pūnaha e tiaki ana i a koe i te mate. He mea whakamiharo? Kei te whakaekehia tātou e ō tātou ake parepare.

Inaianei tirohia, i roto i ō tātou whatukuhu, he miriona ngā tātari iti e horoi ana i te toto. Ka karangatia ēnei ko ngā glomeruli . Pērā i te tātari tī, ka tātarihia e ēnei glomeruli ngā para kore e hiahiatia i roto i te toto, ka tukuna atu i te tinana hei mimi. Ko tētahi atu mahi a ēnei tātari ko te pupuri i ngā mea nui pērā i ngā pūmua e hiahiatia ana e te tinana i roto i te toto.

Ko te mea ka pā ki te tangata whai MN, ko te pūnaha ārai mate, e ai ki taku kōrero, ka whakaeke, ka pakaru hoki i ēnei tātari e kiia nei ko ngā glomeruli. Ina puta tēnei kino, ka nui haere ngā kōhao i roto i ngā tātari. Kātahi ka tīmata ngā pūmua e hiahiatia ana e te tinana ki te tātari mā roto i te tātari, ka puta mai me te mimi. Koinei te raruraru matua o tēnei mate.

Ka puta ohorere mai pea tēnei mate, ka āta whanake haere rānei i roto i te wā. I ētahi wā, kāore pea te tangata e mōhio kei a rātou tēnei mate mō ngā tau.

E rua ngā momo matua o tēnei mate.

E rua ngā wāhanga matua o tēnei āhua o te Membranous Nephropathy (MN). Ka whakarōpūtia tēnei i runga i te pūtake.

Kei a koe anō ēnei tohu?

Ko ngā tohu matua o te mate MN e puta mai ana i te nui o te pūmua e tukuna ana i roto i te mimi, e ai ki taku kōrero i mua ake nei. I roto i te rongoā, ka kiia te kohinga o ngā tohu e puta mai ana i tēnei mate ko te Nephrotic Syndrome .

Ko ngā tohu matua ko ēnei:

• Pupuhi: Te pupuhi, inā koa i ngā waewae, i ngā pona waewae, i ngā waewae, ā, i ētahi wā i te mata me ngā ringa. Ka puta tēnei pupuhi ina heke te nui o te pūmua i roto i te toto, ka turuturu te wai i roto i ngā uaua toto ki roto i ngā kiko.
• Te mimi huka nui rawa (Proteinuria): Nā te nui o te pūmua i roto i te mimi, tera pea ka puta he huka, me te mea he wai hopi.
• Te ngenge nui me te ngenge rawa: Tērā pea ka ngenge tonu koe nā te mea kei te ngaro te pūngao me ngā matūkai e hiahiatia ana e tō tinana.
• Te pikinga ohorere o te taumaha: Ehara i te mea e nui haere ana, engari he pikinga taumaha nā te pupuri wai.
• Te cholesterol teitei: Ina heke te taumata pūmua i roto i te toto, ka nui ake te ngako me te cholesterol e whakaputaina ana e te ate hei whakakapi.
• Te toto toto tiketike: Ka piki ake te toto toto ina ngoikore ngā whatukuhu.
• Te uaua ki te manawa: Ka puta tēnei āhuatanga mēnā ka kohia he wai ki te taha o ngā pukahukahu.

He aha tēnei e tupu ai? He aha ngā take?

Ka rerekē anō hoki ngā take i runga i ngā momo e rua i kōrerohia i mua ake nei.

Te take o te MN tuatahi

I kī ahau ko te MN tuatahi he mate pūnaha ārai mate. Ko te mea e tupu ana i konei ko te tautuhi hē a tō tātou pūnaha ārai mate i tētahi pūmua motuhake e kiia nei ko te kaiwhakawhiwhi phospholipase A2 (PLA2R) i roto i ngā tātari whatukuhu (glomeruli) hei "hoariri." Kātahi ka hangaia he paturopi hei whakangaro i tēnei pūmua PLA2R ka whakaekea. Ko tēnei pakanga te mea e pakaru ai aua tātari, e turuturu ai te pūmua.

Ngā mea ka taea te whakaputa i te MN tuarua

Ko te MN Tuarua he hua nō tētahi atu mea. Anei ētahi mea ka pā ki tēnei:

• Ētahi atu mate pūnaha ārai mate: Ngā mate pēnei i te Lupus me te Rheumatoid Arthritis.
• Ngā Mate Pukupuku: Ngā mate pukupuku pērā i te Hepatitis B, te Hepatitis C, te Malaria, me te Syphilis.
• Matepukupuku: Ina koa ko te matepukupuku o te pūkahukahu me te koroni.
• Ngā rongoā:Te whakamahinga roa o ngā rongoā pēnei i ētahi rongoā whakamamae mamae (NSAID) me te penicillamine.
• Ngā paitini: Te pānga ki ngā konganuku taumaha pērā i te mercury.

He aha ngā raruraru ka pā mai i tēnei?

Ki te kore e rongoatia tika te MN, ka puta pea ngā raruraru nui i roto i te wā.

• Te nui o te cholesterol me te mōrearea o te mate ngakau: Ko te nui o te ngako i roto i te toto ka whakanui ake i te mōrearea o ngā mate pēnei i te mate ngakau me te whiu.
• Ngā toto totoka: Ina puta te pūmua i roto i te mimi, ka puta hoki ngā pūmua e ārai ana i te totoka i te tinana. Ka taea e tēnei te arahi ki te hanganga o ngā totoka i roto i ngā uaua o ngā waewae. Ka kiia tēnei ko te Deep Vein Thrombosis (DVT) . Ki te pakaru tēnei totoka ka mau ki roto i te uaua o ngā pukahukahu, he mate kino, he mate morearea hoki e kiia nei ko te Pulmonary Embolism (PE) .
• Te ngoikore o te whatukuhu: Ki te kore te mate e whakahaeretia, ka piki haere te kino o ngā whatukuhu, ā, i te mutunga ka ngoikore rawa ngā whatukuhu.

Me pēhea te kitenga a te tākuta i tēnei?

Mena kei a koe ngā tohu o runga ake nei, ka tukuna koe e tō tākuta whānau ki tētahi tohunga whatukuhu (Nephrologist). Ka whakahaerehia e ia ētahi whakamātautau hei tātaritanga tika i te mate.

He aha ngā maimoatanga mō tēnei?

Ko te maimoatanga e whakawhirinaki ana ki te momo MN kei ​​a koe me te kaha o ō tohumate. Ko te whāinga matua o te maimoatanga he whakaiti i ngā tohumate me te aukati i te kino haere o te mate.

Ka taea te whakamahi i tētahi, i ētahi atu rānei o ēnei hei rongoā:

• Ngā rongoā toto toto tiketike: Ko ngā rongoā pēnei i ngā aukati ACE me ngā ARB ka whakahaere i te toto toto tiketike, ā, ka whakaiti hoki i te putanga o te pūmua i roto i te mimi.
• Ngā rongoā whakaheke toto: Ka kiia hoki ēnei ko ngā "pire wai." Ka āwhina i te whakaiti i te pupuhi mā te tango i te wai nui mai i te tinana hei mimi.
• Ngā rongoā whakaheke cholesterol (Statins): Ka hoatu ēnei hei whakahaere i ngā taumata cholesterol teitei i roto i te toto.
• Ngā rongoā whakaheke toto: Ka whakamahia ēnei hei whakaiti i te tūponotanga o ngā raruraru pēnei i te DVT.
• Ngā rongoā ārai mate: Ka hoatu ngā rongoā pēnei i te corticosteroids hei pehi i te mahi a te pūnaha ārai mate, hei aukati hoki i tana whakaekenga i ngā whatukuhu.
• Ngā huringa kai: He mea tino nui kia whakaitihia te kai e nui ana te tote me te ngako . Ma tō tākuta koe e tohutohu ki te kai tika.

Mena kāore e ranea ēnei maimoatanga paerewa hei whakahaere i te mate, ka neke pea te tākuta ki ngā maimoatanga kaha ake e kiia nei ko te immunotherapy . Ka whakamahia ngā rongoā pēnei i te Rituximab me te Cyclophosphamide hei whakangaro i ngā pūtau e whakaputa ana i ngā paturopi e whakaeke ana i ngā whatukuhu.

Mō te tangata he MN tuarua tōna, mā te rongoā i te pūtake (hei tauira, te mate hepatitis, te lupus) ka taea te aukati, te whakaiti rānei i te kino o te whatukuhu.

Kei te pēhea te oranga me tēnei mate?

He rerekē te āhua o te mate i ia tangata, i ia tangata. Mō ētahi tāngata, ka memeha katoa te mate me te iti o te rongoā, kāore rānei he rongoā. Mō ētahi atu, ka roa te mate mō ngā tau.

Ko te mea pai rawa atu, iti iho i te 15% o te hunga whai MN ka pāngia e te ngoikore o te whatukuhu, arā, ka taea e te nuinga te noho noa i te ao mā te rongoā.

Engari ko te mea nui kia maumahara ko te hokinga mai o tēnei mate ahakoa kua rongoatia. Nō reira, he mea nui kia haere koe ki ngā wāhi rongoā me te whakamātau i ngā wā kua whakaritea e tō tākuta niho. Kātahi, ki te kitea he tohu kei te hoki anō te mate, ka taea tonu te tīmata i te maimoatanga.