ʻO nephropathy Diabetic: nā hiʻohiʻona o ka papa o ka maʻi a me ka hopena hoʻokokoke

ʻO ka ho'ākāka o ka "diabetes nephropathy" he manaʻo kolamu e hoʻohui pū i kahi paʻakikī o nā maʻi e hopena i ka hoʻopiʻi ʻana i nā moku ma loko o ke kīpē i ke kua o ka maʻi mellitus maʻa.

Hoʻohana pinepine ʻia ka huaʻōlelo ʻo "Kimmelstil-Wilson syndrome" no kēia maʻi, no ka mea ua hoʻohana ʻia nā manaʻo o ka nephropathy a me ka glomerulosclerosis.

No ka nephropathy maʻi ma muli o ICD 10, hoʻohana ʻia nā pāʻālua 2. No laila, ʻo nā code nephropathy diabale ma muli o ICD 10 hiki i nā ʻāpana E.10-14.2 (ʻo ka maʻi diabetes mellitus me ka pōʻino o ka lolo) a me N08.3 (lesi glomerular i ka maʻi diabetes). ʻO ka maʻamau pinepine ka ʻike ʻia ʻana o ka hana renal inal i ka hilinaʻi ʻana i ka insulin, ke ʻano mua - 40-50%, a i ka lua o ka hua ʻole, ʻo ka prevalence o nephropathy ʻo 15-30%.

Nā kumu hoʻolālā

ʻEkolu mau kauka e pili ana i nā kumu kumu o nephropathy:

1. kuai. ^ E Ha yM. ʻO ka manaʻo nui o ke kumumanaʻo ka mana nui o ka hana ʻino i ka kiʻekiʻe o ka glucose i loko o ke koko, ma muli o ke ʻano o ke kahe kai neʻe, a ke waiho ʻia nā momona i loko o nā moku, e alakaʻi ana i ka nephropathy;
2. lawena. ^ E Ha yM. ʻO ia hoʻi, kahi predisposition hoʻoilina i ka maʻi. ʻO ke ʻano o ka manaʻoʻenehana ka manaʻo ʻo ia nā hana genetic e hoʻokō i nā maʻi maʻamau e like me ka maʻi diabetes a me ka maʻi nephropathy diabetes;
3. haemalinnamia. ^ E Ha yM. ʻO ka manaʻo kumumanaʻo me ka maʻi maʻi maʻi maʻi, aia ka lawehala i ka hemodynamics, ʻo ia hoʻi, ka kaʻe o ke koko i loko o nā pūpū, kahi e hoʻonui ai i ka pae o ka albumin i loko o ka pā - i nā mea huna e hoʻopau i nā kīʻaha koko, nā mea e hōʻino ai i nā maʻi (sclerosis).

Eia kekahi, nā kumu no ka hoʻoulu ʻana o ka nephropathy e like me ka ICD 10 pinepine:

• ulaula
• kōpili koko nui;
• ke koko kiʻekiʻe;
• triglycerides maikaʻi a me ka cholesterol;
• anemia

I ka manawa pinepine, ma ka pūʻulu nephropathy, ʻike ʻia nā maʻi ʻē aʻe:

• maʻi maʻamau glomerulosclerosis;
• renal artery atherosclerosis;
• nā ʻāpana o nā waʻa renal;
• nā waihona momona i loko o nā waikā renal;
• pyelonephritis.

Nā Hoʻomaka

ʻO ka mea mua, he mea kūpono e haʻi i ka maʻi maʻi i nā hopena ʻino i nā keiki o ka mea maʻi no ka manawa lōʻihi, ʻaʻole loaʻa i ka mea maʻi.

Hoʻomaka pinepine, ʻike ʻia nā hōʻailona o ka nephropathy maʻi i ka manawa i ka ulu ʻana o ka renal.

I ka wā o ka preclinical stage, ʻike paha nā mea maʻi i ka hoʻonui ʻana i ke koko, proteinuria, a me ka hoʻonui ʻana o 15-25% i ka nui o ka pūpū. I ka papa holomua, ua loaʻa nā maʻi i ka nephrotic-dialetic syndrome, hypertension, a me kahi kaila o ka pae kānana glomerular. Ka hana ʻokoʻa - ka maʻi ʻeha o ka huehue - ka nānā ʻia o ka azotemia, renal osteodystrophy, hypertension arterial a me ka hoʻomau i ka edematous syndrome.

Pehea e holomua ai?

No ka hoʻoholo ʻana i ka nephropathy, ua hoʻohana ʻia ka mōʻaukala a me nā hoʻokolohua hoʻoliʻi. ʻO ke kumu nui i ka hana preclinical e hoʻoholo i ke kiʻekiʻe o ka albumin i loko o ka urine.

Hiki ke hoʻohana ʻia nā hana i kēia hana e hōʻike i ka nephropathy maʻi maʻi e like me ICD 10:

• ka hopena o ka GFR e hoʻohana ana i kahi hoʻokolohua Reberg.
• keiki biopsy.
• ʻO ka Dopplerography o nā keiki a me nā moku peripheral (ultrasound).

Eia kekahi, e kōkua ka ophthalmoscopy e hoʻoholo i ke ʻano a me ke ʻano o ka retinopathy, a me ke elokolohola e kōkua i ka ʻike ʻana i ka hypertrophy hema.

Hoʻomaʻamaʻa

I ka hoʻomaʻamaʻaʻana o nā maʻi o ke keiki, ke kūlana hoʻonā nui ke mālama i ke ʻano o ka maʻi maʻi. Hoʻokō ʻia ka hana koʻikoʻi e ka hana maʻamau o ka lipid metabolism a me ka hoʻokū ʻole ʻana i ke koko. Hoʻohana ʻia ʻo Nephropathy me nā lāʻau lapaʻau e pale aku i nā lolo a me ke koko.

ʻO nā hiʻohiʻona o nā meaʻai e loaʻa ana nā māmā māmā

ʻO kekahi o nā lāʻau ho'ōla keʻai. ʻO ka mea ʻai no ka nephropathy pono e kaupalena i ka ʻai ʻana o nā haʻawina māmā a loaʻa i ka nui o ka protein.

I ka wā e ʻai ai ka ʻai, ʻaʻole i kaupalena ʻia ke koena, no ka mea pono, pono i ka mea puna ke kō i ka pāhare (no ka laʻana, he wai ka wai ʻole) Inā hōʻemi ka mea maʻi i ka GFR, kahiʻaiʻai liʻiliʻi-liʻiliʻi, akā i ka manawa like i loaʻa i ka helu o ka nui o nā calorie, ua ʻōlelo ʻia. Inā hui pū ka nephropathy o ka mea maʻi me ka hypertension arterial, kauoha ʻia kahi meaʻai liʻiliʻi-paʻakai.

ʻO ka maʻi renal pale

Inā hoʻoholo ka mea maʻi i ka wikiwiki o ka kānana glomerular i kahi hōʻailona ma lalo o 15 ml / min / m2, ua hoʻoholo ke kauka hele e hoʻomaka i ka hoʻouka maʻi, hiki iā ia ke hōʻike ʻia e ka hemodialysis, dialysis peritoneal a i ʻole hoʻololi.

ʻO ka manaʻo o ka hemodialysis ka hoʻomaʻemaʻeʻana i ke koko me kahi mea hana "hana maoli". Pono e kaʻina ʻia nā kaʻina hana he 3 mau manawa i ka hebedoma, ma kahi o 4 mau hola.

Pākuʻi peritoneal i ka hoʻomaʻemaʻe i ke koko ma o ka peritoneum. I kēlā me kēia lā, ʻo 3-5 mau manawa e hopu ʻia ana ka mea maʻi me ka hoʻonā dialysis pololei i loko o ka lua o ka ʻōpū. ʻAʻole e like me nā hemodialysis o luna, hiki ke hana ʻia ma ka home.

ʻO ka lawe ʻana aku i ka hakahaka donor he ala maikaʻi loa ia o ka hoʻoulu ʻana i ka nephropathy. I kēia hihia, pono ka mea maʻi e lawe i nā lāʻau lapaʻau e ʻāpono ana i ka ʻōnaehana pale, i mea e pale ai i ka hōʻole hou ʻana.

ʻEkolu ala e pale ai

ʻO ke ala kūpono loa e pale ai i ka hoʻomohala ʻana o ka nephropathy he uku ʻokoʻa no ka maʻi diabetes:

1. ʻO ka pale mua ka pale ʻana o ka microalbuminuria. ʻO nā mea nui no ka hoʻomohala ʻana o ka microalbuminuria: ka lōʻihi o ka maʻi diabetes i ka makahiki 1 a hiki i ka 5 mau makahiki, ka nui o ka ulu ʻana, ka ulaula, retinopathy, hyperlipidemia, me ka hemahema o kahi papa hana hānai;
2. ka hopena o ka lua ma ka hoʻohiolo ʻana i ka hoʻomohala ʻana o ka maʻi i ka poʻe maʻi i hōʻemi ʻia i ke GFR a i ʻole ka nui o nā albumin maʻamau i loko o kā lākou urine. ʻO kēia ʻāpana o ka pale ʻana: kaʻai ʻai palekina haʻahaʻa, kaohi o ke koko, ka hoʻomau ʻana o ka ʻōlelo lipid i ke koko, ka mana o ka glycemic a me ka normalization o ka hemodynamics intrarenal;
3. hana ʻia ma ka papa hoʻonaʻauao ma ka pae o ka proteinuria. ʻO ka pahuhopu nui o ke kūpono ka mea hōʻemi i ka hopena o ka hoʻomohala ʻana o ka hiki ʻole o ka hana renal, a, ma ka huli ʻana, i hōʻike ʻia e: hypertension arterial, lawa ʻole uku no ka metabolism paʻakai, kiʻekiʻe proteinuria a me hyperlipidemia.

Nā wikiō pili

E pili ana i nā kumu a me ke mālama ʻana i ka maʻi nephropathy o ka maʻi ma ka hōʻike TV "Ola ola maikaʻi!" me Elena Malysheva:

ʻOiai ke kūpono ʻole o nā hopena maikaʻi ʻole o ka maʻi mellitus o ka maʻi mellitus, ʻo ke nephropathy kekahi o nā wahi alakaʻi, ka mālama akahele o nā hana pale i hui pū ʻia me ka maʻi manawa kūpono a me ka mālama kūpono e kōkua nui i ka hoʻomau ʻana i ka hoʻomohala ʻana o kēia maʻi.