ʻO ka mea pōʻino pinepine ke kumu i hoʻohālikelike ai i nā palaka, a he pōpilikia nui loa lākou. ʻO ka hōʻeha i nā keiki me ka maʻi hānai e hāʻawi i ka mea hoʻomau i nā pilikia nui. No ka mea no ka mālamaʻana o ka pilikia ʻole, pono e hana ʻia nā hana dialysis. Inā laki ʻoe e ʻike i ka mea hāʻawi, a laila hoʻokō lākou i kahi hana laka. ʻO nā maʻi ʻopa ma ka maʻi maʻi pinepine e hoʻomau i ka make nui no ka poʻe maʻi.
Inā maikaʻi ka diabetes i ka hoʻokele ʻana i ke kō koko, a laila hiki ke pale ʻia nā ʻōpiopio.
ʻO ka nūhou maikaʻi, ke hoʻomau nei ʻoe i ke kōpaʻa koko a kokoke i ka maʻamau, hiki iā ʻoe ke ʻoka e pale i nā pōʻino o ka keiki. No ka hana i kēia, pono ʻoe e hoʻoikaika i kou olakino.
E hauʻoli pū ʻoe i nā hana e pale ai i nā maʻi ʻōpū ke lawelawe pū kekahi i nā hōʻeha o ka maʻi maʻi.
Pehea e hoʻohālikelike ai ka maʻi diabetes
I kēlā me kēia mau pālolo, loaʻa ke kanaka i nā haneli he mau tausani o ka "glomeruli". He mau kānana kēia e hoʻomaʻemaʻe i ke koko o nā lepo a me nā mea momona. Holo ʻia ke koko ma lalo o ke kahe a nā mea liʻiliʻi o ka glomeruli a kānana ʻia. ʻO ka hapa nui o ka wai a me nā mahele koko maʻamau ke hoʻi aku i ke kino. A e hoʻopau, me ke koena liilii wai ʻole, e hele mai mai ka paleha ʻana a hiki i ka ʻōkuhi. A laila e hoʻokaʻawale iā lākou ma waho o ka urethra.
I ka maʻi ʻaina, ke hele a me ke koko me ke kō ka nui o ke kō. Hoʻokaʻawale nā Glucose i nā ʻano wai he nui, ka mea e hōʻemi ai i ka hoʻonaninani ʻana i loko o kēlā me kēia glomerulus. No laila, ke kaila o ka kānana glomerular - he mea nui kēia o ke ʻano o ka maikaʻi o nā keiki - e hoʻonui pinepine i nā papa mua o ka maʻi maʻi. Hoʻopuni ʻia ka glomerulus i kahi kiko i kapa ʻia ʻo ka "membrane basement glomerular". A ke pālahalaha ʻole kēia lamalama, e like me nā ʻili ʻē aʻe e pili pono ana iā ia. A ke hopena, hoʻoiho iki nā kapili i loko o ka glomeruli. Noho ka glomeruli i emi iki, ʻoi aku ka ʻino o ka lolo. No ka mea he kuleana koʻikoʻi o ka pūpū o ke kanaka i ka glomeruli, hoʻomau ka hoʻomau ʻana o ke ʻano hoʻomaʻemaʻe i ke koko.
I ka hopena, heleʻokoʻa nā keiki i ʻike kū ʻia mau hōʻailona o ka maikaʻi ʻole:
- makehewa;
- lie kanikela
- utuka
- nā ninia
- ʻili ka ʻili;
- kaila metallic i loko o ka waha;
- hāliu maikaʻi, hoʻomanaʻo ʻana o ka ʻono o ka urine;
- ka pōkole o ka hanu, ʻoiai me ka liʻiliʻi o ka hoʻoikaika kino a me kahi kūlana hoʻomaha;
- nā puʻupuʻu a me nā kiʻī i nā wāwae, ʻoi aku hoʻi i ke ahiahi, ma mua o ka moe;
- ka nalowale o ka ike, coma.
Loaʻa kēia, ma muli o ke kānāwai, ma hope o nā makahiki he 70 o ka maʻi maʻi, inā e mālama ʻia ka nui o ke koko, ua mālama maikaʻi ʻia ka maʻi diabetes. Hiki i ka Uricemia - ka hōʻiliʻili ʻana o nā paʻikina azoma i loko o ke koko a hiki ʻole i nā mākau i hoʻopili ke hele hou i kahi kānana.
ʻO ka nānā ʻana a me ka nānā ʻana i nā ʻōpū ma ka maʻi maʻi
E nānā i kou mau maʻi no ka maʻi maʻi, pono ʻoe e lawe i nā hōʻike aʻe
- hoʻāʻo ke koko no ka mea hana ʻana;
- nānā pālua no ka albumin a i ʻole microalbumin;
- urinalysis no ka hana.
Hoʻomaopopo i ka pae o ka creatinine i loko o ke koko, hiki iā ʻoe ke helu i ka helu o ka kānana glomerular o nā keiki. ʻIke pū lākou a inā he microalbuminuria ʻole a i ʻole, a ua helu ʻia ke ʻano o ka albumin i ka creatinine i loko o ka iomi. No ka ʻike hou aʻe e pili ana i kēia mau ho'āʻo āpau a me nā hōʻailona o ka hana o ke keiki, e heluhelu i nā "hōʻike ma ka hōʻike e hōʻoia i nā keiki o ka lolo" (wehe i kahi puka aniani).
ʻO ka hōʻailona mua loa o nā pilikia o ke kō ma ka maʻi maʻi ma ka microalbuminuria. ʻO Albumin kahi protein e liʻiliʻi ai kona mau molekula. Ke liʻiliʻi nei nā kauka olakino i kahi liʻiliʻi loa i loko o ka mimi. Ke ulu hou nei kā lākou hana, ua nui ka albumin i ka urine.
Nā hōʻailona Diagnostic o ka albuminuria
Albuminuria i ke kinipōpō kakahiaka, mcg / min | ʻO Albuminuria i kēlā me kēia lā, mg | ʻO ke kūlike o ka albumin i ka urine, mg / l | ʻO ka hoʻohālikelike o ka albumin / creatinine urine, mg / mol | |
---|---|---|---|---|
Normoalbuminuria | < 20 | < 30 | < 20 | <2.5 no na kane a he <3.5 na wahine |
ʻO Microalbuminuria | 20-199 | 30-299 | 20-199 | 2.5-25.0 no nā kāne a he 3.5-25.0 no nā wahine |
Macroalbuminuria | >= 200 | >= 300 | >= 200 | > 25 |
Pono ʻoe e ʻike he nui ka nui o nā albumin i loko o ka pāʻai ʻaʻole paha ma muli wale nō o ka pohō o ka pūpū. Inā inā i pili nui i ka hana kino kino, i kēia lā ʻoi aku ka nui o ka albuminuria ma mua o ka mea maʻamau. Pono e hana i kēia i ka wā e hoʻolālā ana i ka lā o ka hoʻoili. Hoʻonui ʻia ʻo Albuminuria: ka ʻai o ke kalaiwa nui, ke kuni, ka maʻi o ka urinary, hōʻeha o ka puʻuwai, hapai. ʻO ka hoʻohālikelike o ka albumin i ka hanaʻana i loko o ka urine kahi hōʻailona maopopo loa o nā pilikia o ka pūpū. E heluhelu hou aʻe e pili ana ma ʻaneʻi (wehe i kahi puka aniani)
Inā ʻike ʻia ka mea maʻi me ka maʻi maʻi maʻi i nā manawa he nui me ka microalbuminuria, ʻo ia ka mea i loaʻa ka nui o ka loaʻa ʻana o ka maʻi pēpē, ʻaʻole pū kekahi. Inā ʻaʻole i mālama ʻia, a laila maʻa hope, i lilo ka mana o ka filtration o nā palupalu i nā nāwaliwali, a me nā mea nui o nā ʻōnaehana o kahi nui o ka nui i loko o ka urine. Kāhea ʻia kēia proteinuria.
ʻOi aku ka maikaʻi o ka nāhepū, ʻoi aku ka nui o ka mea hana ma loko o ke koko. Ma hope o ke koho ʻana i ka helu filtration glomerular, hiki ke hoʻoholo i ke ʻano o ka hōʻino o ka maʻi o ka palaka.
Nā ʻōpū o nā maʻi o ke aʻalolo, e pili ana i ka helu filtration glomerular
ʻO nā maʻiʻino o kaʻeha | ʻO ka helu filtration Glomerular (GFR), ml / min / 1.73 m2 |
---|---|
Kāne lāʻau | > 90 |
1 | > 90, me nā hōʻike hōʻike e hōʻike ana i nā hōʻike pili o nā pilikia o ka pūpū |
2 | 60-90 - ʻaʻa moloki ʻole |
3-A | 45-59 - hōʻino nā kino o nā manamana |
3-i | 30-44 - nā hōʻeha hōʻeha hōʻemi |
4 | 15-29 - pilikia hōʻeha |
5 | <15 a i ʻole dialysis - ka maikaʻi ʻole o ka renal hina |
Hoʻomaopopo i ka papa. Hōʻikeʻike i nā pilikia o ke akepaʻa e hōʻike ana i nā hoʻokolohua a me nā hoʻokolohua. Hiki iā ia:
- microalbuminuria;
- ka proteinuria (ka hele mai o nā molekū protein nui i loko o ka urine);
- koko i loko o ka urine (ma hope o ua hoʻoholo ʻia nā kumu ʻē aʻe);
- nā mea hoʻoponopono hemahema, nāna i hōʻike i kahi ultrasound o nā pūpū;
- ʻO ka glomerulonephritis, i hōʻoiaʻiʻo ʻia e kahi maʻi biopsy.
Ma ke kānāwai, hoʻomaka nā hōʻailona i ʻike ʻia i ka wā nui o ka 4 o nā maʻi kaulike. A hele nā hana mua a pau me nā hōʻike ʻole o waho. Inā hoʻohuli ia i ka nānā ʻana i nā pilikia o ka keiki ma kahi o ka hoʻomaka ʻana a hoʻomaka i ka mālama ʻana i ka manawa, a laila pale ʻia ka hoʻomohala ʻana o ka hana pilikia ʻole. Eia hou, paipai mākou i ka lawe mau i kāu mau hoʻokolohua maʻamau ma ka liʻiliʻi hoʻokahi i ka makahiki, e like me ka mea i hōʻike ʻia ma ka ʻāpana "He aha nā hoʻokolohua e hana ai e nānā i kāu mau maʻi." I ka manawa like, hiki iā ʻoe ke nānā i nā nui o nā urea a me ka ʻula uric i loko o ke koko.
ʻO nā papa maʻi diabetes 2 ʻelua e ʻae ʻia e nā ʻāpana like ʻole o ka maʻi puʻuwai
Ka lāʻau | ʻO nā ʻōpū o ka hanaʻino o ka pūpū, kahi i ʻae ʻia e noi ai |
---|---|
Metformin (Siofor, Glucofage) | 1-3a |
ʻO Glibenclamide, me ka micronized (Maninyl) | 1-2 |
ʻO Gliclazide a me Gliclazide MV (Glidiab, Actos) | 1-4* |
Glimepiride (Amaryl) | 1-3* |
Hoʻopau | 1-4 |
Glipizide, e pili ana i ka lōʻihi (Movogleken, Glibens retard) | 1-4 |
Repaglinide (NovoNorm, Diagninid) | 1-4 |
ʻAno Hoʻopuka (Starlix) | 1-3* |
Pioglitazone (Aactos) | 1-4 |
Lehuauka (Januvius) | 1-5* |
Vildagliptin (Galvus) | 1-5* |
Saxagliptin (Onglisa) | 1-5* |
Linagliptin (Trazhenta) | 1-5 |
Exenatide (Baeta) | 1-3 |
Liragiale (Victoza) | 1-3 |
Acarbose (Glucobai) | 1-3 |
Insulin | 1-5* |
Hoʻomaopopo i ka papa.
* Ma 4-5 mau manawa o ka pōʻino, pono ʻoe e hoʻoponopono i ka nui o ka lāʻau. Eia nō hoʻi, ke hoʻomau nei ka maʻi ʻōpū, ka iho ʻana o ka hōʻohi i ka insulin i ke kino. Hoʻonui kēia i ka pilikia o ka hypoglycemia. No laila, pono e hoʻoponopono ʻia nā dosages insulin i lalo.
ʻO nā maʻi e pilikia ana i ka ulu ʻana o ka hiki ʻana o ka pūpū.
ʻO nā ʻ oflelo o nā maʻi | Ehia mau e nānā ʻia ai |
---|---|
ʻO nā maʻi maʻi maʻi 1 ka maʻi e pili ana i ka wā kamaliʻi a ma hope o ka wā ʻōpiopio | 5 mau makahiki ma hope o ka hoʻomaka ʻana o ka maʻi diabetes, a laila makahiki |
ʻO nā maʻi maʻi maʻi 1 ka maʻi maʻi i ka wā ʻōpiopio | Ma ke ʻano koke, i kēlā me kēia makahiki |
Nā maʻi maʻi maʻi maʻi 2 | Ma ke ʻano koke, i kēlā me kēia makahiki |
ʻO nā wahine hāpai i ka maʻi maʻi a i ʻole ka maʻi maʻi gestational | 1 mau manawa hoʻokūkū |
ʻO ka pale ʻana i nā pōʻino o ka pūpū i ka maʻi diabetes
Hoʻoulu ka maʻi palaka maʻi ma kahi o 1/3 o nā mea maʻi me ka maʻi type type 1 a me type 2, ʻo ia hoʻi, mamao loa i nā mea āpau. Pehea paha ʻoe e loaʻa ai nā hōʻailona o ka loaʻa ʻole o ka pūpū i hilinaʻi ʻia i nā hopena o nā hōʻike i hōʻike ʻia ma ka pauku i hala. Lawe i nā hōʻike a kūkā i kā lākou hopena me kāu kauka.
He aha kāu e hana ai e pale aku i ka pōʻino o ka lolo i ka maʻi diabetes:
- mālama i ke kōhi koko i ka maʻamau - ʻo ia ka mea nui
- aʻo i ka ʻatikala "Diet for kidney with diabetes";
- hoʻopaʻa pinepine i ke kahe o ke koko ma ka home me ka tonometer (pehea e hana pololei ai i pololei ka hopena);
- pono ke ʻano o kou koko maʻamau, ma lalo o 130/80;
- hana i nā hōʻike e nānā i nā hana o nā keiki i ka liʻiliʻi o ka manawa 1 ma ka makahiki;
- hana i nā mea pono e mālama ai i ke kō, ke koko, ke kolamu a me nā momona koko, me ka lawe ʻana i nā lāʻau lapaʻau i kauoha ʻia e kāu kauka;
- pipili i ka meaʻai kūpono no ka maʻi maʻi (i kēia hihia, he ʻokoʻa loa nā loiloi “limahana” mai kā mākou, heluhelu ma lalo i kēia ʻatikala);
- hana i nā hana hoʻomaʻamaʻa maʻamau, e ho'āʻo i nā hana home ma nā dumbbells māmā, kahi palekana loa no nā keiki;
- inu i ka waiʻona "maʻi hoʻomaʻemaʻe maoli," mai inu ʻole;
- kū ʻole ka ulaula;
- e ʻike i kahi kauka maikaʻi nāna e "alakaʻi" i kāu maʻi maʻi, a hele pinepine iā ia.
Ua hōʻike maopopo ʻia nā haʻawina i ka lawaiʻa ʻana he kumu nui ia e hoʻonui ai i ka hiki o ka hoʻomohala ʻana i ka lolo ʻole i ka maʻi maʻi diabetes. ʻO ke kāpae ʻana i ka ulaula ʻaʻole ia kahi loiloi alualu, akā ka mea koʻikoʻi.
ʻO ka hoʻomaʻemaʻe ʻana i ka maʻi maʻi paleka
Kuhi aku ke kauka i ka mālama ʻana i ka maʻi no ka maʻi maʻi, ma muli o ke ʻano o ko lākou lesion. ʻO ke kuleana koʻikoʻi no ka hana ʻana i nā papa inoa e waiho pū me ka mea maʻi. Ke hilinaʻi nei kekahi mea i nā lālā o kāna ʻohana.
Hoʻonohonoho mākou i nā kumu nui o ka lāʻau no ka maʻi o nā maʻi ma ka maʻi diabetes:
- ka mālama paʻa ʻana o ke kō koko;
- hoʻohaʻahaʻa i ke koko i kahi pae kūpono o 130/80 mm RT. ʻAniā. a lalo;
- ka mālama ʻana i kahi papa kūpono no nā pilikia o ka lolo maʻi;
- ka hoʻomalu ʻana i ka cholesterol a me ka triglycerides (nā ʻoka) i ke koko;
- dialysis;
- kidney transplant.
ʻO ka ʻatikala "Nā Diabetic Diabetic" e kamaʻilio nei i ka mālama ʻana o ka maʻi paleka i ka maʻi diabetes i nā kikoʻī nui. E nānā pū "Diet no nā pūpū me ka maʻi maʻi."
ʻO nā maʻi a me nā palaka: ʻo ka mea e pono ai ʻoe e hoʻomanaʻo
Inā pilikia nā pilikia, a laila hoʻāʻo ka koko no ka likaline a me ka urine no microalbuminuria hiki ke ʻike koke iā lākou. Inā hoʻomaka ka mālama ʻana i ka manawa, hoʻonui nui kēia i ka manawa o ka kūleʻa. No laila, ʻo nā hoʻokolohua i hōʻike ʻia ma ʻaneʻi (e wehe ʻia i kahi puka aniani) pono kau ʻia i hoʻokahi manawa i hoʻokahi makahiki. E noʻonoʻo e hoʻohana i kahi kīʻaha haʻahaʻa-mau kaola e hoʻohiolo i kāu kōʻai koko. E heluhelu hou i loko o ka ʻatikala "Diet for kidney with diabetes."
No nā maʻi maʻi he nui ke koko, ʻo ka hoʻohui ʻana i nā lāʻau lapaʻau, hoʻopili ʻia ka paʻakai i kā lākou papaʻai e kōkua. E hoʻāʻo e hōʻemi i kāu kaomi ʻana o ka sodium chloride, i.e. papa paʻakai, a loiloi i nā hopena āu e loaʻa ai. He pilikino kēlā me kēia kanaka i ka paʻakai.
ʻO kekahi hoʻopiʻi hou, maʻi neuropathy maʻi, hiki ke hōʻino i nā ʻōpū i mālama i ka ʻeha. I kēia hihia, hiki ke kīnā i ka wehe ʻana i ka ipu. I loko o ka urine, e waiho mau ana i nā manawa a pau, kahi maʻi e hōʻino ʻana i nā keiki i ka nui. I ka manawa like, ma nā maʻi maʻi maʻi i hiki ai i ka hoʻololi i kā lākou koko koko, huli pinepine ka neuropathy me ke hoʻololi ʻia, i.e., holo piha loa.
Inā paʻakikī ʻoe i ka ʻili ʻana a i ʻole nā hōʻailona ʻē aʻe o kahi maʻi urinary, e ʻike koke i kāu kauka. Hiki i kēia mau pilikia ke hoʻolōʻihi i ka hoʻomohala ʻana i nā pilikia hakahaka i ka maʻi diabetes.