He tūponotanga tēnei ki ō whatukuhu anō hoki? (Renal Papillary Necrosis) Kia ako tātou mō tēnei!

E mōhio ana koe ki te nui o te mahi a ngā whatukuhu iti e rua i roto i tō tātou tinana? Inaa, ko ngā whatukuhu ngā whekau matua e tātari ana i ngā para me te horoi i te toto i roto i tō tātou tinana. Heoi, i ētahi wā ka pāngia hoki ēnei whatukuhu e ngā mate kāore e tumanakohia ana e tātou. I tēnei rā ka kōrero tātou mō tētahi mate he ahua kino, engari ki te mōhio koe ki tēnei, ka taea e ia te āwhina i a koe ki te whakahaere me te ārai.

He aha te Renal Papillary Necrosis?

Ki te kī ngāwari, he rite ō tātou whatukuhu ki ngā tātari tino pai e rua i roto i tō tātou tinana. Ko tā rātou mahi matua he tātari i ngā para kore e hiahiatia i roto i te toto, ka tukuna hei mimi. Hei mahi i tēnei, ka uru te toto ki roto i ngā whatukuhu, ka haere mā roto i ngā awaawa iti maha. Ka kohia ēnei para mai i te taha o waho o te whatukuhu, kātahi ka tae ki waenganui o te whatukuhu, arā, te medulla whatukuhu . Anei ngā wāhanga āhua-taura. Ko te pito o ēnei taura, e kiia nei ko te papilla renal, ka kohia te mimi. Mai i reira, ka haere te mimi mā roto i ngā ureter ki te pūkahukahu, ka puta ki waho. Koinei te mahi a ō tātou whatukuhu.

Ko te mate pāwera o te whatukuhu e kōrerohia nei e tātou ko te matenga o ngā pūtau me ngā kiko i waenganui o te whatukuhu (`Medulla`) me te papilla whatukuhu (`Renal Papilla`) i kōrerotia e au i mua ake nei. Whakaarohia, ina kore aua wāhi e mahi tika, kāore e mahi tika te mahi a ngā whatukuhu, tika? Nā tēnei, ka ngoikore haere ngā whatukuhu, ā, i te mutunga ka arahi pea ki te ngoikore o te whatukuhu .

Ko wai te mea tino mōrearea ki tēnei mate?

Ko tēnei mate (Renal Papillary Necrosis) te mea e tino kitea ana i roto i te hunga neke atu i te 60 tau te pakeke. E tohu ana hoki ngā tākuta he nui ake te tūponotanga o te pāngia o ngā wāhine i ngā tāne.

He aha ngā take o te Renal Papillary Necrosis?

He maha ngā tino take e whai wāhi ana ki te putanga mai o tēnei mate. Me titiro tātou ki ērā.

• Mate Huka : Koinei te tino take nui, tino noa hoki. Ko te hunga kāore i te tino whakahaeretia te mate huka, he nui te tūponotanga ka pakaru ō rātou whatukuhu. Ka pakaru ngā oko toto ngawari o ngā whatukuhu i ngā taumata huka toto tiketike mō te wā roa.
• Te whakamahi nui rawa i ngā rongoā mamae mamae (NSAID) : Ki te whakamahi tonu koe i ngā rongoā mamae mamae (ngā rongoā anti-inflammatory kore-steroidal, NSAID rānei) pērā i te aspirin, ibuprofen, naproxen rānei mō te wā roa, me te kore e kōrero ki te tākuta, me tino tupato koe. Mēnā ka nui rawa te tango i ēnei, ka whaiti ngā oko toto i roto i ngā whatukuhu, ka kino hoki ngā papillae whatukuhu.
• Mate Pūtau HāripaHe mate ira tēnei. I roto i tēnei mate, ka huri te āhua o ngā toto whero, ā, ka mau pea ki roto i ngā oko toto. Ka taea hoki e tēnei te arahi ki te ngoikore o te rere o te toto ki ngā whatukuhu (Renal Papillary Necrosis).

Haunga ēnei take matua, he maha atu anō ngā āhuatanga ka puta ai te Renal Papillary Necrosis:

• Mate Ate Mau tonu
• Ko te Pyelonephritis, he mate huakita o ngā whatukuhu (ka kino pea ngā papillae whatukuhu)
• Te mate kohi whatukuhu, he mate e pā ana ki ngā whatukuhu i waho o ngā pukahukahu
• Te toto totoka i roto i te uaua whatukuhu (te toto totoka i roto i te uaua e kawe ana i te toto mai i ngā whatukuhu)
• Te aukati i te mimi (hei tauira, nā ngā kohatu mimi)
• Vasculitis, he mumura o ngā oko toto

Ko te mea nui, ehara i te mea ka pāngia te Renal Papillary Necrosis e te mate pāwera o te uma, ahakoa kua pāngia e tētahi, e ētahi rānei o ēnei take, engari he nui ake te mōrearea.

Ka pā tēnei ki ngā whatukuhu e rua?

Ae, e ai ki ngā pūrongo, mō te whitu o roto i te tekau o ngā tāngata , ka pāngia ngā whatukuhu e rua e tēnei āhuatanga (Renal Papillary Necrosis).

He aha ngā tohu o te (Renal Papillary Necrosis)?

I ngā wāhanga tōmua o tēnei mate, kāore pea he tohu . Koia te uaua ki te kite me te rongoā wawe. Whakaarohia, kāore he raruraru āu, engari kua pakaru pea ō whatukuhu mai i roto. Heoi anō, tera pea ka kitea tūponotia tēnei i te wā e whakamātautauhia ana mō tētahi atu mate.

Heoi, ina kaha haere te mate (Renal Papillary Necrosis), ka puta pea ēnei tohu:

• Te mimi mamae (Dysuria)
• Te kirika me te makariri (ina koa mēnā he mate pāwera kei te haere tahi)
• Te toto i roto i te mimi (`Hematuria`) - Ka kitea pea te nui o te toto e te kanohi tahanga (ka whero, ka parauri rānei te mimi), ka iti rawa rānei, ā, ka kitea noa i raro i te karuārai.
• Te hiahia tonu ki te mimi i te pō ('Nocturia')
• He pikinga rerekē o te maha o ngā toto ma i roto i te mimi (`Pyuria`) - ko te tikanga ka rite te mimi ki te pūkahukahu, ā, ka puta te mimi ki te kapua.
• Te mamae nui i ngā taha e rua o te tuara, i waenganui i ngā rara me ngā wheua hope (kei hea ngā whatukuhu). Ka pā mai pea tēnei mamae i te wā ohorere, i te wā rānei ka piki haere.
• Ngā mate urutā auau o te ara mimi.

Me pēhea te tautuhi i te Renal Papillary Necrosis?

Ka whakahaerehia e ngā tākuta ētahi whakamātautau hei tautuhi i tēnei mate (Renal Papillary Necrosis). Whai muri i te whakarongo ki ō tohu me tō hītori hauora, ka tonoa pea e rātou he whakamātautau pēnei i:

• Te whakamātautau miroKo te tikanga o tēnei ko te tango i tētahi hihi-X, i tētahi matawai CT, i tētahi MRI rānei o ō whatukuhu. I mua i te whakamātautau, ka hoatu he tae motuhake (he tae) mā roto i tētahi uaua. Mā tēnei ka kitea mārama ngā wāhi kua pakaru ngā whatukuhu me ngā huringa o ngā papillae.
• Ureteroscopy : Ko te whakaurunga o tētahi ngongo angiangi, ngāwari (me te kāmera i te pito) mā roto i te urethra hei tirotiro tika ki roto i te pūkahukahu, ngā ureter, me ngā whatukuhu. Mā tēnei ka kitea mārama te āhua o ngā papillae.
• Kohikohi ira o te whatukuhu : I tēnei whakamātautau, ka tangohia he wahi iti o te kiko mai i te whatukuhu mā te whakamahi i tētahi ngira motuhake, ā, ka tirohia i raro i te karu hiko. Ka āwhina tēnei ki te whakatau mēnā kua mate ngā pūtau, kua pakaru rānei te kiko.

Ngā whakamātautau toto me te mimi

Hei tāpiritanga, he mea tino nui anō hoki ngā whakamātautau toto me te mimi hei tirotiro i te mahi a te whatukuhu:

• Whakamātautau hauota urea toto (BUN) : Mā tēnei ka ine i te nui o te hauota urea i roto i te toto. He para tēnei. Ka piki ake tēnei taumata i roto i te toto ina kore e mahi tika ngā whatukuhu.
• Whakamātautau Creatinine : Ko te Creatinine tētahi atu para e puta ana i te wā e mahi noa ana te uaua. I te nuinga o te wā ka tukuna atu e ngā whatukuhu. Mena he teitei tōna taumata i roto i te toto, he tohu anō hoki kāore ngā whatukuhu e mahi tika ana.
• Te Whakatau Tata o te Auau Tātaritanga o te Hukapapa (eGFR) : Ka tatauhia tēnei mā te whakaaro ki ngā āhuatanga pēnei i te taumata creatinine o tō toto, te tau, te ira tangata, me te rahi o tō tinana. Mā te uara eGFR ka whakaatu ki a koe te nui o te toto e tātarihia ana e ō whatukuhu ia meneti. Ko te iti iho o tēnei uara, ko te iti ake o te mahi a ō whatukuhu.
• Te tātari mimi : Ko te tango i tētahi tauira mimi ka tirotirohia mā te tirohanga (tae, māramatanga), mā te tirotiro i roto i te mimi iti (mō ngā pūtau toto, ngā pūtau pūkahukahu, ngā huakita, ngā para papillary), me te tirotiro matū (mō te pūmua, te huka). I ētahi wā, ka kitea hoki ngā kongakonga o ngā papillae whatukuhu i raro i te tirotiro i roto i te mimi iti.
• Te ōwehenga pūmua/creatinine mimi : Mā tēnei ka ine i te nui o te pūmua kei roto i te mimi. He iti noa te pūmua ka puta mai i ngā whatukuhu hauora. Ko te nui o te pūmua i roto i te mimi he tohu nō te kino o te whatukuhu.

He aha ngā raruraru ka pā mai i te (Renal Papillary Necrosis)?

Ki te kore tēnei āhuatanga (Renal Papillary Necrosis) e rongoatia tika, ka kino haere te āhua, ā, ka arahi atu ki ngā raruraru nui.

• Te Mate Tākihi Mau tonu (CKD) : Nā te kino tonu o ngā tākihi, ka heke haere te mahi a aua tākihi, ā, ka hua ake te mate tākihi mau tonu.
• Te ngoikore o te whatukuhuKi te kino haere te āhua, ka mutu pea te mahi a ngā whatukuhu, ko te tikanga ka pāngia rātou e te ngoikore o te whatukuhu.
• Hei oranga, me dialysis (te horoi i ō toto ki te mīhini) me te whakawhitinga whatukuhu rānei.
• Kua kitea hoki ka piki ake te mōrearea o te whakawhanake i tētahi momo mate pukupuku e kiia nei ko te mate pukupuku pūtau whakawhiti, e puta ana i roto i te whatukuhu, i te ureter rānei, nā tēnei āhuatanga.
• Tērā anō te mōrearea o te pangia kino (sepsis).

Me pēhea te rongoā i te Renal Papillary Necrosis?

Kāore he rongoā motuhake mō te Renal Papillary Necrosis. Ko te rongoā matua ko te rongoā i te pūtake o te mate . Hei tauira:

• Mena he mate huka te take, he mea nui kia pai te whakahaere i te mate huka.
• Mena nā te whakamahinga NSAID, kati te tango i aua rongoā.
• Mena he mate pāwera te take, hoatu he rongoā paturopi.
• Mena he aukati kei roto i te ara mimi, me tango.

Ko te whāinga matua he whakawhāiti i ngā kino atu ki ngā whatukuhu, me te tiaki i te mahi a te whatukuhu i ngā mea katoa e taea ana.

Ko te angitu o te maimoatanga e whakawhirinaki ana ki te nui o te kino o te whatukuhu me te pūtake o te mate. I ētahi wā tino kino, ka haere tonu te kino o te mate ahakoa te maimoatanga. Heoi, i ngā wā iti ake te kino, ā, ki te tere te rongoā i te pūtake, ka pumau pea te mahi a te whatukuhu, ka pai ake rānei.

Ka taea e au te tiaki i a au anō mai i te Renal Papillary Necrosis?

Ae, tera ētahi mea ka taea e tātou te mahi hei tiaki i a tātou i tēnei āhuatanga, ki tētahi taumata nui.

• Ko te mea nui ko te pupuri i tō hauora whānui . He mea nui te kai i tētahi kai taurite, te inu wai nui, me te whakakori tinana i ngā wā katoa .
• Mena kei te tango koe i ngā rongoā mamae kore utu (NSAID), whakamahia kia rite ki ngā tohutohu kei runga i te kete, ki ngā tohutohu rānei a te tākuta. Kaua e tangohia i ngā wā maha, mō te wā roa, mō te wā roa rānei. Kaua e tangohia i ngā wā katoa mō ngā mamae iti, ngā ānini rānei.
• Mena kei a koe te mate huka (Diabetes Mellitus), te mate pūtau hāripiri (Sickle Cell Disease), ētahi atu mate rānei ka pā mai te mate tākihi (Renal Papillary Necrosis), me whai i ngā tohutohu a tō tākuta. Haere ki te whare hauora i te wā tika. Tangohia ngā rongoā kua tohua. Whai i te kai tika.
• He mea tino nui kia whakamātauria ngā whakamātautau taiwhanga hei tirotiro i te mahi a te whatukuhu i ngā wā katoa e ai ki ngā tohutohu a tō tākuta, kia kitea ai hoki ngā huringa i te wā wawe.

He aha te auau whakaora mō te tangata e pāngia ana e tēnei mate?

Ko tō matapae ka whakawhirinaki ki te pūtake o te mate, te nui o te kino o te whatukuhu, tō hauora whānui, me te tere o te tīmatanga o te maimoatanga.

• Mō te hunga mate huka, tērā pea kāore i te tino pai ngā hua , nā te mea he mate roa te mate huka, ā, kāore i te pai te whakahaere i ngā wā katoa. Mēnā he mate huka tōu, mā te whakahaere pai i tōna āhua ka āwhina nui ki te ārai i te kino o te whatukuhu.
• I ngā take kino (Renal Papillary Necrosis), ka taea te arahi ki te dialysis me te whakawhitinga whatukuhu . Mēnā ka pā mai te mate, ka mate pea. Tērā pea ka mate koe i te ngoikore o te whatukuhu.
• I roto i te mate pūtau hāripiri, ko te necrosis papillary whatukuhu tētahi o ngā raruraru maha ka puta i roto i ngā whatukuhu. Ina whakakotahihia ēnei raruraru katoa, ka tino whakaitihia te roanga o te oranga o te tūroro.

Āhea ahau me toro atu ki te tākuta?

Mena kei a koe tētahi, ētahi rānei o ēnei tohu, kaua e whakaroa, me toro atu ki te tākuta :

• Mena he toto kei roto i tō mimi (ka huri te mimi ki te whero, ki te māwhero, ki te parauri rānei).
• Mena kei te pāngia koe e te kirika, e te makariri rānei (ina koa me ētahi atu tohu).
• Mena ka mamae koe, ka wera rānei i te wā e mimi ana.
• Mena he mamae hou, he mamae kino rānei kei ngā taha e rua o tō tuara, kei waenganui i ngā wheua hope me ngā rara (te rohe tākihi).
• Mena ka pāngia koe e ngā mate mimi i ngā wā maha.
• Mena ka iti haere te mimi, ka pupuhi rānei ō waewae me ō pona waewae (he tohu pea ēnei o te ngoikore o te mahi a te whatukuhu).

Kia maumahara, ka taea hoki ēnei tohu te puta mai i ētahi atu mate. Heoi, he mea nui kia tirohia koe e te tākuta kia kitea ai te tino take.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He okana tino nui ō tātou whatukuhu mō tō tātou tinana, e mahi puku ana i tētahi mahi nui. Ka tātarihia e rātou ngā para, ka pupuri i te taurite o te wai me te tote i roto i te tinana. Ka taea e te mate huka kore e whakahaeretia, te whakamahi nui i ngā rongoā whakamamae mamae (NSAID), me ētahi atu mate hauora te kino i ngā whatukuhu, ka arahi atu ki ngā mate kino pēnei i te Renal Papillary Necrosis.

Ko te mea tino kino o tēnei mate, kāore pea he tohu i ngā wāhanga tōmua. Nō reira, ki te mea he mate huka koe, he kaiwhakamahi NSAID auau rānei, he take mōrearea rānei kei a koe mō te mate tākihi, kōrero ki tō tākuta mō ngā huarahi hei tiaki i ō tākihi. Mā te tirotiro i ō tākuta i ia wā, me te whai i tētahi momo oranga hauora, ka taea e koe te pupuri i te hauora o ō tākihi. Ko te mōhio wawe me te mahi i ngā wā katoa te mea pai rawa atu hei mahi.

` Whākihi, mate pukupuku papillary whatukuhu, mate whatukuhu, mate huka, NSAID, ngoikore o te whatukuhu, mimi