He aha ngā wāhanga o te mate tākihi mau tonu? Kia mārama tātou i roto i ngā kupu māmā noa iho.

Kua kōrerotia mai e te tākuta he mate tākihi tōu, he ngoikore rānei? Kua rongo rānei koe he mate tākihi tō tētahi e mōhio ana koe? He mea noa te mataku me te manukanuka ina rongo koe i ēnei kupu. Engari ki te mōhio tātou ki tēnei, ka taea te whakaiti i taua mataku ki tētahi taumata nui. Nō reira, i tēnei rā, me kōrero tātou mō tēnei mate tākihi roa, arā, ko te 'Mate Tākihi Mau tonu (CKD)', he aha ōna wāhanga rerekē, me ngā mea me mahi e tātou i ia wāhanga.

He aha i wehea ai te mate tākihi (CKD) kia maha ngā wāhanga?

He whakarāpopototanga noa iho, ko te CKD he āhuatanga e heke haere ana te mahi a ngā whatukuhu i roto i te wā. Kāore tēnei e puta katoa i te wā kotahi. Koia te take e whakarōpū ai ngā tākuta i te mate ki ngā wāhanga 1 ki te 5 kia mārama ai ki tōna kaha.

Whakaarohia he rite ki te arawhata. Ina kei runga koe i te arawhata, ka pai te mahi a ō whatukuhu. I a koe e heke ana, ka heke te mahi a ō rātou whatukuhu.

• Ngā wāhanga tōmua (ngā wāhanga 1-3): I ēnei wāhanga, kei te pai tonu te mahi a ō whatukuhu, kei te taumata noa rānei. I te nuinga o te wā, kāore he tohu nui e kitea ana i tēnei wāhanga.
• Ngā wāhanga whakamutunga (ngā wāhanga 4-5): I tēnei wāhanga, kua tino heke te mahi a te whatukuhu. I te wāhanga whakamutunga, kua tata kore e mahi pai ngā whatukuhu.

Me pēhea te whakatau i ēnei wāhanga? He aha te GFR?

Āe, kia tirohia tātou me pēhea e taea ai e te tākuta te kī tika kei tehea taumata koe. Ka whakatauhia tēnei mā te titiro ki te "tere tātari" o ō whatukuhu.

He rite ngā whatukuhu e rua o tō tātou tinana ki ngā tātari wai e rua. Ko te mahi matua a ngā whatukuhu he tātari me te pure i ngā para kore e hiahiatia, te wai nui me ngā tote mai i te toto, ā, ka tukuna atu hei mimi. E miriona ngā waeine tino iti kei roto i ngā whatukuhu e mahi ana i tēnei tukanga tātari. Ka karangatia rātou ko ngā '(nephrons)'. Ko te tātari matua i roto i ia o ēnei nephrons ka karangatia ko te '(glomerulus)'.

Ko te ine i te tere o te horoinga o ō toto mā roto i ēnei tātari ka kiia ko te Glomerular Filtration Rate , ko te GFR rānei.

Ina pakaru ngā whatukuhu, ka heke te tere tātari (GFR). Nā te mea he uaua ki te ine tika i tēnei GFR, ka inehia e ngā tākuta te nui o te para e kiia nei ko te "creatinine" i roto i ō toto, kātahi ka whakamahia hei tatau i tō GFR mā te whakamahi i tētahi whārite motuhake, pērā i tō tau me tō ira tangata. Ka kiia tēnei ko te GFR estimate , ko te eGFR rānei.Koinei te uara kua whakarārangihia hei eGFR i roto i tō pūrongo toto.

Hei tāpiritanga, ka mahia he whakamātautau mimi hei tirotiro mō te pūmua (albumin) i roto i te mimi. I ētahi wā, ahakoa he noa te eGFR, ka taea e te pūmua i roto i te mimi te tohu wawe o te kino o te whatukuhu.

Ngā wāhanga o te CKD me ō rātou tikanga

Koinei te uara eGFR e whakamahia ana hei whakarōpū i ngā wāhanga e 5 o te CKD. Ka taea e koe te mārama mā te titiro ki tēnei ripanga.

He aha ngā tohu ka kitea i ia wāhanga?

Ko tētahi o ngā āhuatanga ahurei o te CKD ko te rerekētanga o ngā tohu i runga i te wāhanga o te mate.

Ngā Wāhanga 1 me te 2

I ēnei wāhanga tōmua, kāore he tohu o te nuinga o te tangata nā te mea kei te pai tonu te mahi a ō rātou whatukuhu. Ka kitea noa iho i te nuinga o te wā ina mahia he whakamātautau toto, mimi rānei mō tētahi atu mate, ina tirohia rānei te toto toto. Engari, tera pea ka kite ētahi i ngā mea pēnei i:

• Te pupuhi o ngā ringa, ngā waewae, ngā pona rānei
• Ngā mate urutā mimi auau
• Mimi huka

Ngā Wāhanga 3a me 3b

I te hekenga haere o te mahi a te whatukuhu, ka uaua ake te urutau o te tinana ki tēnei mate. Koinei te wā ka tīmata te maha o ngā tāngata ki te pāngia e ngā tohu.

• Te pupuhi o ngā waewae me ngā pona
• Te whakahekenga taumaha me te ngaronga o te hiahia kai
• Te ngenge me te kore ora
• Ngā mamae o te uaua
• Te uaua ki te manawa
• Te kore moe
• Kiri mākūkū
• Te hiahia tonu ki te mimi, ina koa i te pō
• Mimi pahuka, mimi pouri rānei

Ngā Wāhanga 4 me te 5

I tēnei wā, kāore ngā whatukuhu e mahi tika ana, ā, ka tīmata te kohikohi o ngā para o te tinana ki roto i te toto. Ka taea e tēnei te arahi ki ngā raruraru nui. Haunga ngā tohu kua whakahuatia i runga ake nei, ka puta pea ēnei e whai ake nei:

• Te uaua ki te arotahi
• Ānini
• Mamae o raro o te puku
• Te wiri i roto i ngā ringa me ngā waewae
• Whakapairuaki me te ruaki
• Te whakaiti, te mutu rānei o te mimi
• Manawa kino
• Te rerekētanga o te kiri (te huri ki te hina, ki te kōwhai rānei)

He aha ngā maimoatanga mō te mate whatukuhu?

Kāore anō kia kitea he rongoā mō te CKD. Heoi anō, ka taea e te maimoatanga te whakahaere i ngā tohu me te whakaroa i te haere whakamua o te mate. He rerekē ngā kōwhiringa maimoatanga i runga i te wāhanga o te mate.

Te maimoatanga mō ngā wāhanga 1 me te 2

Ko te whāinga matua i tēnei wā ko te ārai i ngā kino atu ki ngā whatukuhu. Tērā pea ka tūtohu tō tākuta i ēnei e whai ake nei:

• Ki te kai paipa koe, kati tonu.
• Te kai i ngā kai hauora, he iti te tote me te hinu.
• Te whakakorikori tinana i ia wā, i ia wā.
• Te whakahaere i te taumaha o te tinana.
• Ki te mea he mate huka koe, me whakahaere pai te taumata o te huka i roto i tō toto.
• Ki te mea he toto toto tiketike tōu, me whakahaere.

Te maimoatanga mō ngā wāhanga 3a me 3b

I tēnei wā, me ngā huringa āhua noho, tera pea e hiahiatia ana ngā rongoā hei whakahaere i te mate.

• Ngā rongoā mō te toto toto tiketike: Ahakoa kāore koe i te toto toto tiketike, ka taea e ētahi rongoā te whakaiti i te kino ki ō whatukuhu.
• Rongoā whakaheke cholesterol.
• Ngā rongoā mate huka: Ko ētahi rongoā, inā koa ko ngā aukati SGLT2, ka hoatu hei tiaki i ngā whatukuhu ahakoa mō te hunga kāore he mate huka.
• Diuretics: Āwhina ki te tango i te tote me te wai taapiri mai i te tinana.
• Ētahi atu rongoā: Papa rino, ētahi atu huaora rānei hei pupuri i te kaha o ngā wheua me te ārai i te mate toto.

Te maimoatanga mō ngā wāhanga 4 me te 5

Ina tata te ngoikore o ngā whatukuhu, kāore e ranea te rongoā anake hei pupuri i te hauora o te tinana. Ko ngā kōwhiringa maimoatanga matua e rua i tēnei wā ko:

• Dialysis: He mīhini e tango ana i te toto mai i ō whatukuhu.
• Te whakawhitinga whatukuhu: Ko te whakawhitinga pokanga o tētahi whatukuhu hauora ki roto i te tinana.