Nā hoʻāʻo ʻana i ka hana ʻāʻī (KFT)

He aha ka hana maʻamau o nā puʻupaʻa?

He ʻano pīni nā puʻupaʻa a ua like ka nui me ka lima. Aia ʻelua mau puʻupaʻa ma nā ʻaoʻao ʻelua o ke kuamoʻo, ma hope o ka ʻōpū a ma lalo o ka iwi ʻaoʻao.

Mālama nā puʻupaʻa i ka pae o ka wai o ke kino a me nā minelala koʻikoʻi like ʻole. Kānana lākou i nā mea ʻōpala a me ke kahe keu mai ke koko a hoʻokuke aku iā lākou mai ke kino aku ma ke ʻano he mimi.

ʻO nā hana ʻē aʻe o nā puʻupaʻa e komo pū ana me ka hana ʻana o:

• Vitamin D
• Nā hunaola ʻulaʻula
• Nā hormones e hoʻoponopono ai ke koko,

He aha nā hōʻailona o nā pilikia puʻupaʻa?

ʻO nā hōʻailona e hōʻike ana i kahi pilikia me nā puʻupaʻa:

• Ke kaheʻie kiʻekiʻe
• He koko i loko o ka urine
• Koi pinepine e mimi
• Ka paʻakikī e hoʻomaka ana i ka mimi ʻana
• Urination ʻeha
• ʻO ka pehu o nā lima a me nā wāwae 

I ka manawa hea e ʻōlelo ai ke kauka i kahi KFT?

• inā ka kauka manaʻo paha ʻaʻole hana nā puʻupaʻa ma muli o nā kumu pilikia, nā hōʻailona lapaʻau, a me nā ʻōuli
• No ka nānā ʻana a me ka loiloi ʻana i ke kumu o ka hana ʻole o ka puʻupaʻa
• Inā he mau kūlana e hiki ke hōʻeha i nā puʻupaʻa, e like me diabetes a i ʻole ke koko kiʻekiʻe, e noho pū ana
• No ka nānā ʻana i ka holomua o ka maʻi puʻupaʻa a me ka pane ʻana i ka lāʻau lapaʻau

He aha nā ʻano o nā KFT?

ʻO nā ʻano hana like ʻole no ka loiloi ʻana i ka hana o ka puʻupaʻa:

• ʻĀninalysisNānā ia no ka protein, ke koko, ka pus, ka bacteria, a me ke kō i loko o ka mimi. Hiki iā ia ke kōkua i ka ʻike ʻana i nā ʻano puʻupaʻa like ʻole a me nā maʻi ʻeha, me maʻi nā konāhua mai, ka maʻi diabetes, nā maʻi ʻōpū mimi, a me nā pōhaku puʻupaʻa. No ka mea, he nui nā kumu no ka protein i loko o ka mimi, ʻaʻole paha he kumu kumu mau ka maʻi puʻupaʻa. Hiki i ke kauka ke hana hou i kēia hoʻāʻo ma hope o kekahi mau pule e ʻike ai inā like nā hopena. Pono kekahi mau hoʻāʻo mimi i kahi liʻiliʻi wale nō, aʻo nā mea ʻē aʻe e koi i ka hōʻiliʻili mimi i nā hola he iwakāluakūmāhā i hala. E hōʻike kahi hoʻāʻo mimi 24 hola i ka nui o ka mimi a kou mau puʻupaʻa e hana ai a ana pololei i ka maikaʻi o ka hana ʻana o kou mau puʻupaʻa i kēlā me kēia lā.

E hoʻolako ʻia kahi pahu no ka hōʻiliʻili ʻana i ka laʻana mimi a laila e hoʻouna ʻia i kahi lab no ka nānā ʻana ma ke keʻena lapaʻau o ke kauka a i ʻole haukapila. 

• Pūmua mimi: ʻO ka loaʻa ʻana o ka protein i loko o ka mimi ua kapa ʻia ʻo proteinuria. Hiki ke loaʻa kēia ana ma ke ʻano he ʻāpana o ka urinalysis a i ʻole kahi hoʻāʻo dipstick. Pono e hōʻoia ʻia kahi hoʻāʻo dipstick maikaʻi (≥1+) e:

• Ke nānā ʻana i ka microalbuminuria: He hoʻāʻo dipstick koʻikoʻi kēia e hiki ke ʻike i kahi liʻiliʻi o ka albumin (ke ʻano maʻamau o ka protein urinary). ʻOi aku ka nui o ka albumin i loko o ka mimi e hōʻailona paha i ka hana pono ʻole o ka renal. ʻO nā kānaka i pilikia no ka hana pono ʻole o ka renal (no ka laʻana, ʻo ka poʻe me diabetes or hypertension) pono e hana i kēia hoʻāʻo a i ʻole ka lakio albumin-to-creatinine (ACR) inā maikaʻi ʻole kā lākou hoʻāʻo dipstick maʻamau no ka proteinuria.
• ʻACR: Ke puʻunaue mākou i ka nui o ka albumin urinary me ka creatinine urinary, loaʻa iā mākou ka ACR. ʻO ka ACR < 30 ua manaʻo ʻia he maʻamau. ʻO ka ACR ma waena o 30-300 e hōʻike ana i ka albuminuria kaulike. ʻO ka ACR > 300 ke ʻano o ka albuminuria koʻikoʻi. 

• Ka Hoʻomaʻemaʻe ʻana o Creatinine: Hoʻohālikelike kēia loiloi i ka pae creatinine i loko o kahi hāpana mimi 24-hola i ka nui o ka creatinine i loko o ke koko e hōʻike i ka nui o nā huahana ʻōpala e kānana nei nā puʻupaʻa i kēlā me kēia minuke.

• Nā hāpana koko: ʻO nā hoʻokolohua ʻelua e pono ai ke lawe ʻia ʻana o kahi hāpana koko ma ke keʻena lapaʻau a i ʻole kahi haukapila o ke kauka, ʻo ia ka BUN a me nā hoʻokolohua serum creatinine. Hoʻopaʻa mua ke loea i kahi kaula elastic a puni ka lima o luna, kahi e ʻike nui ʻia ai nā aʻa koko ma ke kūlou o ka lima. Hoʻomaʻemaʻe ke loea i ka wahi ma luna o ke aʻa koko, a ma hope iho e hoʻokomo lākou i kahi nila hakahaka ma o ka ʻili a i loko o ke aʻa koko, e kahe ana ke koko i loko o kahi paipu hoʻāʻo. Ma hope o ka hoʻāʻo ʻana, e kau ke loea i ka gauze a me kahi bandage ma luna o kahi i hou ʻia. E hoʻouna ke loea i ka paipu i kahi lab no ka nānā ʻana.

• Hoʻāʻo creatinine serum: He huahana haki maʻamau ka Creatinine o ka ʻaʻahu kino o nā ʻiʻo, kahi i kānana piha ʻia mai ke koko e nā puʻupaʻa. Wahi a ka National Kidney Foundation, ʻo ka pae creatinine > 1.2 milligrams/deciliter (mg/dL) no nā wahine a > 1.4 mg/dL no nā kāne e hōʻike ana i ka hana pono ʻole o nā puʻupaʻa. Me ka hana pono ʻole o nā puʻupaʻa, piʻi ka pae o ka creatinine i loko o ke koko. ʻO ka hoʻāʻo serum creatinine kahi loiloi koʻikoʻi o ka hana renal a hoʻoholo i ka piʻi ʻana o ka serum creatinine.

• Naikokene urea koko (BUN): ka Hoʻāʻo BUN Kōkua i ka hoʻoholo ʻana i ka nui o ka urea nitrogen, kahi huahana haki o ka protein meaʻai, i loko o ke koko. Me ka hōʻino ʻia o nā puʻupaʻa, hiki ke kū mai ka BUN kiʻekiʻe mai ka lawe ʻana i kekahi mau lāʻau lapaʻau, me ka aspirin a me kekahi mau ʻano antibiotics. Pono nā kānaka e hoʻomaopopo i kā lākou kauka e pili ana i kā lākou mōʻaukala lawe lāʻau a me nā mea hoʻohui. Inā koi ʻia kēia hoʻāʻo, pono ke kanaka e hoʻōki i kēia mau lāʻau lapaʻau no kekahi mau lā ma mua o ka hoʻāʻo. ʻO ka pae BUN maʻamau mai 7 a me 20 mg/dL. I ka emi ʻana o ka hana renal, piʻi ka pae BUN, a ʻo kahi waiwai kiʻekiʻe e hōʻike i nā pilikia olakino, me ka hana ʻole o nā puʻupaʻa.

• Ka helu kānana Glomerular (GFR): Hōʻike kēia i ke ʻano o ka kānana ʻana o nā puʻupaʻa i nā ʻōpala a me ke kahe keu mai ke koko. Hiki iā mākou ke hoʻoholo i ka helu ma ka noʻonoʻo ʻana i nā ʻano lapaʻau like ʻole:
  • Pae creatinine serum
  • makahiki
  • hoohanau
  • Makuakane
  • kiʻekiʻe
  • Weight

Ke ana nei kēia hoʻāʻo i ka maikaʻi o ka wehe ʻana o nā puʻupaʻa i nā ʻōpala a me ke kahe keu mai ke koko. Hiki ke loli ka GFR maʻamau e like me ka makahiki (hiki ke emi me ka makahiki). Hiki iā mākou ke helu i ka GFR ma ke ʻano he milliliters/minute/1.73m²ʻO ke kumukūʻai maʻamau no GFR he 90 a ʻoi aku paha. ʻO ka GFR ma lalo o 60 e hōʻike ana ua hoʻomaka kekahi ʻano hana pono ʻole o ka renal. Inā hāʻule ka GFR o kekahi ma lalo o 15, aia lākou i ka pilikia kiʻekiʻe o ke koi ʻana dialisis a i ʻole he hoʻoili ʻana.

Nā hoʻokolohua kiʻi e hiki ke kōkua i ka hoʻohui ʻana i nā hōʻailona me KFTs

• 'Ohanahana a me CTHiki ke hoʻohana ʻia e nānā i nā ʻano ʻē i ka nui a i ʻole ke kūlana o nā puʻupaʻa a i ʻole nā ​​​​mea e ālai ana e like me nā pōhaku a i ʻole nā ​​​​puʻupuʻu.
• Pono paha mākou i kahi kopa nā lāʻau kanu ma nā kūlana aʻe:
  • No ka ʻike ʻana i ka hoʻomaka ʻana o ka maʻi a me ka holomua a hoʻoholo i ka pane kūpono i ka lāʻau lapaʻau
  • No ka loiloi ʻana i ka nui o ka hōʻino ʻana o ka renal 
  • No ka ʻike ʻana i nā kumu ka mea kanu transplant hōʻole

He aha nā ʻano hana e mālama ai i nā maʻi puʻupaʻa mua?

Inā hōʻike nā KFT i ka maʻi puʻupaʻa ma lalo, e kuhikuhi ke kauka i ka pathology kumu. Ma waho aʻe o ke aʻo ʻana i ke kanaka e pili ana i ke ʻano o ka nohona a me nā hoʻololi ʻana i ka meaʻai, hiki i nā kauka ke kuhikuhi i nā lāʻau lapaʻau e kāohi i ke koko kiʻekiʻe a me ka maʻi diabetes. He kuhikuhi i kahi ke kanaka hulihonua or endocrinologist pono paha ma muli o nā hopena hoʻāʻo a me ke kiʻi lapaʻau holoʻokoʻa. Pono nā KFT hou e nānā i ka holomua a me ka pane ʻana i ka lāʻau lapaʻau. 

ʻŌlelo Hoʻolaha: No ka ʻike wale nō kēia ʻatikala a ʻaʻole ia he pani no ka ʻōlelo aʻo lapaʻau. E kūkākūkā me kahi loea mālama ola kino no ka ʻike ʻana, ka mālama ʻana, a i ʻole nā ​​hopohopo.