Kua whakaarohia e koe te pūnaha tātari whakamiharo o tō tinana? He rite ki te tātari hinu i roto i te motuka, he whekau nui ō whatukuhu e tātari ana i ngā para i roto i ō toto, e pupuri ana hoki i tō hauora. He maha ngā wā, kāore tātou e whakaaro ki a rātou kia puta rā anō he raruraru. Mena kua pupuhi ō waewae, kua roa rānei te ngenge, he tohu whakatūpato pea ēnei mō te mate whatukuhu. Me matapakihia tēnei i tēnei rā i roto i te huarahi māmā, mārama hoki.
He aha te mahi a ō whatukuhu?
E rua ngā whatukuhu o tātou katoa, kei ia taha o tō tuaiwi, i raro noa iho i tō rara. He nui te mahi a ēnei okana iti e rua.
Ki te kī māmā noa, ka haere te toto katoa o tō tinana mā roto i ō whatukuhu kia tātarihia i ia 30 meneti. Whakaarohia te maha o ngā wā ka puta tēnei i roto i te rā kotahi!
Ina ora ō whatukuhu, ka mahia e rātou ēnei mahi nui:
| Ngā Mahi Matua o te Tākihi | Whakamārama Māmā |
|---|---|
| Te Tātari Para | Ka tangohia e rātou ngā paitini i te kai, i te rongoā, me ngā mahi noa a te tinana, ka tukuna atu mā te mimi. |
| Taurite Wai me te Kohuke | Ka whakahaere i ngā taumata wai, ka whakahaere hoki i ngā kohuke pēnei i te konutai me te pāhare pāporo, ka tangohia te taikaha. |
| Te Whakahaere i te Pēhanga Toto | Ka whakaputahia e rātou he homoni e kiia nei ko te Renin hei āwhina i te pupuri i te pumau o tō toto toto. |
| Te Hanganga o ngā Pūtau Toto Whero | Ka hangaia e rātou te homoni erythropoietin, hei tohu i tō tinana kia hanga ngā toto whero, hei ārai i te anemia me te ngenge. |
| Whakahohenga Huaora D | Ka hurihia e ō whatukuhu te Huaora D hei tōna āhua hohe, he mea nui mō te kaha o ngā wheua. |
Ina pāngia koe e te kino o te whatukuhu , ka kore e angitu ēnei tukanga. Ka kohikohi ngā paitini me te wai nui i roto i tō pūnaha. Ka arahi pea tēnei ki te pupuhi o te waewae , te whakapairuaki , te ngenge/ngoikore ,ngā raruraru moe , me te poto o te manawa . Ki te kore e rongoatia tika, ka piki ake tēnei kino ki te ngoikore katoa o te whatukuhu, he āhuatanga ohorere e morearea ana ki te ora. Ki te whakaaro koe kei a koe ēnei tohu, whakapā atu ki ngā ratonga ohorere (911) me toro atu rānei ki tō hōhipera tata tonu.
He aha ngā momo matua o te mate tākihi?
He maha ngā momo mate tākihi me mōhio koe.
Te Mate Tākihi Mau tonu (CKD)
Koinei te momo tino noa. Ko te tikanga o te CKD ka heke haere te kaha o ō whatukuhu ki te tātari i ngā para me te wai nui mai i ō toto. Kāore tēnei e puta i te pō kotahi; ka āta whanake haere mō te wā roa. Ko te āhuatanga tino morearea o te CKD ko te korenga o ngā tohu i ngā wāhanga tōmua.
Mā te rongoā tika ka taea te whakaroa i te whanaketanga o tēnei mate. Ki te kore, ka eke pea te mate ki te Wāhanga Mutunga o te Mate Tākihi (ESRD), e hiahiatia ana he dialysis, he whakawhitinga tākihi rānei. Ko te mate huka me te toto toto tiketike ngā tino take o te CKD.
Ētahi atu momo mate tākihi
- Te Mate Tākihi Polycystic: He āhuatanga ira e puta ai ngā pūkahukahu ki runga i ngā tākihi, ka whakaiti i tō rātou kaha ki te tātari para.
- Lupus Nephritis: He mate pūnaha ārai mate e whakaeke ai te pūnaha ārai mate o te tinana i ōna ake kiko tākihi.
- Glomerulonephritis: He kino ki ngā wae tātari iti i roto i ngā whatukuhu, ka puta pinepine i muri i ngā mate pēnei i te korokoro strep.
- Pyelonephritis: He mate tākihi e puta mai ana i te mate mimi kua horapa. Ki te kore e rongoatia, ka puta he whara mō te wā roa.
He aha ngā take o te mate whatukuhu?
Ko ngā take o te mate ka wehea kia rua ngā wāhanga i runga i te āhua o te whanaketanga.
1. Whara Whatukuhu Whakapeka (AKI)
He ngaronga ohorere tēnei o te mahi a te whatukuhu, e puta pinepine ana i:
- Te whakahekenga o te rere o te toto ki ngā whatukuhu.
- Te whara tika ki ngā whatukuhu.
- Te aukati i te rere o te mimi.
Ka puta pea ēnei āhuatanga nā te whara nui, te matewai, te sepsis, ngā kohatu mimi, te rahinga rānei o te repeure, te pānga ki ētahi rongoā paitini, ngā raruraru hāputanga rānei.
2. Te Mate Tākihi Mau tonu (CKD)
Ki te kore e mahi pai ō whatukuhu mō te neke atu i te 3 marama, ka tohua he mate pūkahukahu (CKD) i te taha hauora. Ko ngā take matua e rua ko:
- Mate Huka: Ka pā kino te huka toto kore e whakahaeretia mō te wā roa ki ngā oko toto ngawari o ō whatukuhu.
- Te toto toto tiketike: Ka nui te taumahatanga o ngā oko toto whatukuhu nā te toto toto tiketike mau tonu, ā, ka mutu ka kino.
Hei tāpiri, ko te whakamahinga roa o ētahi rongoā whakamamae mamae (pēnei i ngā NSAID/Ibuprofen), te pānga ki ngā paitini, me ngā āhuatanga tuku iho, ka arahi pea ki te mate pūkahukahu (CKD).
Te Hononga i waenganui i te Waipiro me ō Whatukuhu
Whakaarohia ō whatukuhu hei pūnaha tātari matatau o tō tinana—e mahi uaua ana rātou ki te tango i ngā paitini me ngā para. Ina inu waipiro koe, ka utaina e koe he taumahatanga tāpiri, kāore e tika ana ki tēnei pūnaha. Nā te mea ka akiakihia ō whatukuhu ki te mahi kaha ake i te tikanga ki te tukatuka i te waipiro, ka taea e te whakamahinga tonu te whakararu nui i tō hauora whatukuhu.
Ka taea e te inu nui te whakararu i te whatukuhu ohorere, te whara nui. Hei tāpiri, ko te inu nui tonu i te waipiro tetahi o ngā tino take o te toto toto tiketike (hypertension), koinei tētahi o ngā tino take o te mate whatukuhu mau tonu (CKD).
Te Mōhio ki ngā Tohu Whakatūpato
He maha ngā wā ka kiia te mate tākihi he mate "mūmū" nā te mea ka haere tonu, kāore he tohu e kitea ana tae noa ki te wā e puta ai he kino nui. I ngā wāhanga tōmua, tera pea ka pai tō āhua. I te haere tonu o te mate, tera pea ka kite koe i ngā tohu whakatūpato e whai ake nei:
- Te toto toto tiketike kāore i te whakahaeretia.
- Whakapairuaki me te ruaki.
- Te ngaronga o te hiahia kai.
- He reka konganuku pumau i roto i tō waha.
- Te ngenge, te ngoikore rānei kāore i te mārama.
- He uaua ki te arotahi, he "kohu roro" rānei.
- Ngā raruraru moe.
- Ngā mamae uaua me te mamae ā-rohe.
- Te pupuhi i ō waewae me ō pona waewae (edema).
- Kiri mau tonu, kiri mākūkū.
- Te mamae o te uma (mēnā ka nui haere te wai i te taha o te ngākau).
- Te poto o te manawa (mēnā ka nui haere te wai i roto i ngā pukahukahu).
Me pēhea te tautuhi i te mate whatukuhu?
Hei whakaatu i te āhua o tō hauora, ka arotakehia e tō tākuta tō hītori hauora whānau, ngā rongoā o nāianei, me ngā huringa katoa o ō tauira mimi. Whai muri i te whakamātautau tinana, ka tonoa pea e rātou ngā whakamātautau e whai ake nei:
- Ngā whakamātautau toto: Hei ine i ngā taumata o ngā hua para pēnei i te urea me te creatinine.
- Te tātari mimi: Hei tirotiro mō te pūmua, ētahi atu tohu rānei o te turuturu/kino o te whatukuhu.
- Ngā whakamātautau whakaahua: Mā te ultrasound ka taea e tō tākuta te tiro i te hanganga me te rahi o ō whatukuhu.
- Kohikohi whatukuhu: Ka tangohia he tauira kiko iti mō te tātaritanga taiwhanga hei whakatau i te tino pūtake o te kino.
Ngā Kōwhiringa Maimoatanga me Nirogi Lanka
Ahakoa ka taea te whakaora i ētahi momo mate tākihi, ko te mate tākihi mau tonu (CKD) me whakahaere mō te wā katoa. Heoi, mā te wawaotanga hauora tika, ka taea e koe te whakaroa i te haere whakamua o te mate me te tiaki i te mahi tākihi e toe ana.
Tērā pea ka tukuna koe e tō tākuta tiaki tuatahi ki tētahi Tohunga Niho—he tohunga e aro nui ana ki te hauora o te whatukuhu—hei whakarite i tō tiaki.
1. Ngā rongoā
- Te Whakahaere i te Pēhanga Toto: He mea tino nui te whakahaere i tō pēhanga toto. Tērā pea ka tohua e tō tākuta ngā aukati ACE, ngā ARB rānei, e kore e whakaiti noa i te pēhanga toto engari e tiaki ana hoki i ō whatukuhu mā te whakaiti i te turuturu o te pūmua ki roto i te mimi.
- Te Whakahaere Mate Huka: Ko ētahi rongoā hou, pērā i te Dapagliflozin (Farxiga), kua whakaatu i te angitu whakamiharo ki te tiaki i te mahi a ngā whatukuhu, ahakoa i roto i ngā tūroro kāore he mate huka.
- Ngā Maimoatanga mō te Korekore o te Āninia: Ina pakaru ngā whatukuhu, ka iti ake te homoni erythropoietin e whakaputaina ana e rātou, ka hua ake te korekore o te āninia. Ka taea e tō tākuta te whakarato maimoatanga hei whakahaere haumaru i tēnei.
He Whakatūpato Hira: Ki te mea he mate tākihi tōu, kaua rawa e tango i ngā rongoā mamae ka hokona noa i te toa rongoā, inā koa ko ngā NSAID pēnei i te Ibuprofen, i te Naproxen rānei, me te kore kōrero ki tō tākuta. Ka taea e ēnei te whakararu i ō tākihi, ā, ka kore e taea te whakaora. Me kōrero tonu ki tō tīma hauora i mua i te tīmatanga o tētahi tāpiringa hou, rongoā hou rānei.
2. Te Whakamahere Kai
Tērā pea ka tūtohu tō tākuta i tētahi kai motuhake he iti te konutai (tote), te pāhare pāporo, me te phosphate hei whakaiti i te mahi a ō whatukuhu. Ka taea e tētahi tohunga kai whatukuhu te āwhina i a koe ki te waihanga i tētahi mahere kai e hāngai ana ki ngā hiahia motuhake o tō tinana.
3. Te Dialysis
Ina kore e taea e ngā whatukuhu te tātari toto, ka mahi te dialysis i tēnei mahi nui:
- Te whakaheke toto:Ka tātarihia ō toto e tētahi mīhini o waho, ka whakahokia ki tō tinana.
- Dialysis Peritoneal: Ka whakamahia e tēnei te arai o tō puku hei tātari i te toto i roto i tō tinana.
Ka matapakihia e tō tākuta te kōwhiringa e tino pai ana mō tō āhua noho.
4. Te Whakatō Whatukuhu
Ki te tini, ko te whakawhitinga toto te paerewa koura mō te hauora mō te wā roa. Ko te tikanga o tēnei ko te pokanga ki te whakanoho i tētahi whatukuhu hauora mai i tētahi kaituku ki roto i tō tinana. Ahakoa ka kore e hiahiatia he dialysis i tēnei wā, me piri tonu ki ngā rongoā ārai-whakakore mō te wā katoa.
He Pānui mai i Nirogi Lanka
- He mate "mū" te mate tākihi, kāore e whakaatu i ngā tohu tōmua .
- Ko te mate huka me te toto toto tiketike ngā tino take mōrearea. Whakaritea te whakahaere i ēnei.
- Mena he nui tō mōrearea, whakaritea he whakamātautau auau (whakamātautau toto me te mimi) me tō tākuta.
- Āta karohia te whakamahi roa i ngā rongoā whakamamae mamae NSAID me te kore he tirotiro hauora a te tohunga.
- Ki te whiwhi koe i te tātaritanga, kia noho pai—he tino whai hua ngā maimoatanga hou ki te āwhina i a koe ki te pupuri i te oranga kounga teitei.
Ngā Kupumatua: Mate Tākihi, Hauora Tākihi, Mate Tākihi Mau tonu, CKD, Dialysis, Whakatō Tākihi, Mate Huka me ngā Tākihi
