ʻO ke kīnā ʻole o ke kīnā ʻole ʻaʻole e holo pono ke kīʻaha o ka pōpoki (s) a ʻaʻole hiki iā lākou ke hana i kā lākou mau hana. He mea nui ia e ʻike pehea e ʻike ai i ka ʻokoʻa hōʻeha ākea loa mai ka hōʻino ʻole o ke kōpaʻa paʻa. I kekahi hihia, inā ʻaʻohe ou kanalua iki e pili ana i ke olakino o kāu pōpoki, mai hoʻokaʻulua e hoʻokaʻaʻike aku i kāu kauka holoholona.

I mea e maopopo ai ka hopena o ka puʻuwai, he mea nui e noʻonoʻo i ka hana o ka puʻupaʻa. ʻO ke kuleana nui o ka hope e kānana i ke koko o ke kino i mea e hana ai i ka mimi (kahi i loaʻa i ke kō o ke koko) akā ma luna o nā mea āpau e mālama i ka hoʻohui o ke kūpaʻa o ke koko. Hāʻawi pū ia i ka synthesive o kekahi mau hormones. ʻO ka nephron ka ʻāpana hana o ka hakuʻala. He mau haneli kaukani o kēlā me kēia pūpū a ʻo ia kēia mau mea e hōʻoia i ka hana o ka kānana. I ka hanana maikaʻi ʻole o ke kōpaʻa, ʻaʻole hana hou ʻia ke kānana no ka mea ua hōʻino ʻia kekahi mau nephrons. Ma muli o ka hana ʻole o lākou āpau, ʻilihune ka kānana.

I nā pōpoki, hiki ke hoʻohuli pinepine ʻia (AKI) hikiwawe a hoʻi koke ia, ʻaʻole like me ka hōʻino kīwī mau loa (CKD) e hoʻomaka mālie a ʻaʻole hiki ke hoʻi.

Hiki i nā kumu he nui ma ke kumu o kahi ARI e like me ka hemorrhage, kaʻai ʻana i kahi mea ʻona (e laʻa me kahi mea kanu) a i ʻole mea keakea i ke kahe o ka mimi. Hiki iā mākou ke nānā i kahi hōʻeha hōʻeha i ke kūlana maʻamau o ka pōpoki (luaʻi, diarrhea, dehydration a i ʻole kahi kūlana haʻalulu e pili ana i ke kumu) a i ʻole paʻakikī i ka mimi.

He mea nui e hoʻomanaʻo e hiki i kahi ARI ke pani i kahi pilikia, no laila pono ʻoe e lawe koke i kāu pōpoki i kāu kauka lāʻau no ka lāʻau.

ʻO ka hōʻino kīnā ʻole ʻoiaʻiʻo hōʻino ʻia nā puʻupaʻa a hōʻino ʻole ʻia no 3 mau mahina. 

Pono nā hōʻailona hōʻailona e noʻonoʻo iā ʻoe e pili ana i ke kūkā kūkākūkā ʻana me kāu kauka holoholona a ʻoi loa kēia.

• Polyuro-polydipsia: ka mimi ka mimi he nui a inu i ka wai hou aku. ʻO ia ka hōʻailona mua o ke kāhea ʻana e ʻike pehea e ʻike ai. ʻOiaʻiʻo, ke hōʻino ʻia nā nephrons, pono i nā hana ʻē aʻe e hōʻoia i ka nui o ka ukana filtration e hoʻonui ana i ka nui o ka mimi. I ka hoʻohui, ʻaʻole hiki i ka hakuʻala ke noʻonoʻo hou i ka mimi i hoʻoheheʻe ʻia (mimi melemele māmā loa). I mea e uku ai no kēia nalo ʻana o ka wai i ka mimi, e inu hou ka pōpoki. Eia nō naʻe, paʻakikī kēia e ʻike i nā pōpoki, keu hoʻi i nā mea e noho ana i waho.

Hōʻike nā ʻōuli maʻi i lalo i nā pae holomua ke hōʻino nui ʻia nā puʻupaʻa:

• Kaumaha emi;
• Ka nele o ka makemake;
• ʻAhuʻula huluhulu;
• Hiki paha ka luaʻi;
• Make wai.

PalekanaEND_LINK

E mālama pono kāu kauka holoholona i kāu holoholona me nā hoʻokolohua hou aʻe (hōʻike i ke koko no ka hōʻiliʻili, palpation o nā puʻupaʻa, ka mimi aniani, kiʻi, a me nā mea ʻē aʻe) i mea e hōʻoia ai a ʻaʻole ʻole e hōʻeha a hōʻeha i ke kumu. Kaukaʻi ʻia i ka ʻino o ka hakuʻala a me nā hopena o nā anamanaʻo, ua hoʻonohonoho ʻia kahi hoʻonohonoho IRIS (International Renal interest Society) i mea e hāʻawi ai i kahi pae maʻi i ka pōpoki. ʻOiaʻiʻo, kahi hoʻokolohua koko e hiki ai ke hoʻoholo pehea e holo ai ke kānana o nā puʻupaʻa, ke mahalo nui i nā pae o ka creatinine, urea a me SDMA (Symmetric DiMethyl Arginine, kahi amino acid) i loaʻa i ke koko. Hoʻopau pinepine ʻia kēia mau mea i ka mimi. Ke pololei ʻole ka kānana, e hōʻiliʻili lākou i ke koko. ʻO ke kiʻekiʻe o kā lākou nui, ʻoi aku ka maikaʻi o ka kānana a no laila ʻoi aku ka hōʻino ʻana i ka puʻupaʻa.

No laila, i nā pōpoki, eia nā pae 4 IRIS e hiki mai ana.

• Kahua 1: pae creatinine maʻamau, ʻaʻohe hōʻailona, ​​kiʻekiʻe aʻe paha ka pae SDMA;
• ʻOihana 2: pae maʻamau ka creatinine a i ʻole kiʻekiʻe iki aʻe ma mua o ka maʻamau, hiki ke loaʻa o nā ʻōuli akahai, pae kiʻekiʻe SDMA kiʻekiʻe aʻe;
• ʻOihana 3: nā kiʻekiʻe o ka creatinine a me ka SDMA ma mua o ka maʻamau, ke kū ʻana o nā ʻōiwi hōʻino (polyuropolydipsia) a me ka laulā (nalo o ka makemake, ka luaʻi, ka pohō kaumaha, a pēlā aku);
• ʻOihana 4: nā kiʻekiʻe kiʻekiʻe o ka creatinine a me ka SDMA pae, ʻo ka pōpoki i loko o ka pae o ka CRF a he nui ka pōʻino i kona kūlana olakino.

He mea nui e hoʻomanaʻo i ka holomua o ke kahua, ka ʻilihuna o ka wānana. ʻO ka maʻamau, ʻaʻole hōʻike ʻia nā ʻōuli a lohi, ke nāwaliwali loa ka puʻupaʻa, no ka mea, i nā wā mua e hiki ai i nā puʻupaʻa ke uku no ka nalowale holomua o nā nephrons.

Pili ka lāʻau lapaʻau i kau ʻia ma ke kahua o ka pōpoki a me nā ʻōuli e hōʻike ai. I nā hihia koʻikoʻi loa, ʻoi aku i nā hihia o ka make wai, pono pono i ka haukapila.

ʻO ka hoʻomaʻamaʻa nui he loli i ka papaʻai. No laila he mea pono e hoʻololi i kahi papa lāʻau lapaʻau i hoʻomākaukau ʻia no nā pōpoki me ka hōʻino ʻole o ka puʻuwai ma o ka hoʻololi ʻana i ka meaʻai. ʻOiaʻiʻo, ʻo kēia papaʻai e ʻae iā ia e mālama i kāna mau puʻupaʻa a hoʻonui i ka lōʻihi o kona ola. Eia hou, he mea nui e hāʻawi mau i ka pōpoki i ka wai hou a palena ʻole. Hiki i ke kaohi wai ke alakaʻi i ka make wai.

He mea nui e hoʻomanaʻo i ka makahiki o ka pōpoki kahi pae e noʻonoʻo ai. ʻO kēia no ka hana maikaʻi ʻole o nā puʻupaʻa o nā pōpoki me ka ʻelemakule, no laila e ulu ana ka maʻi maʻi maʻi mau. Loaʻa nā laina meaʻai i kēia manawa e kākoʻo i ka hana hakuʻala o nā pōpoki kiʻekiʻe a pale i ko lākou holo pono ʻole. Mai kānalua i ke kūkākūkā ʻana me kāu kauka holoholona.

Hoʻonohonoho ʻia kekahi mau ʻano e hoʻomohala i kekahi mau maʻi puʻuwai, i loko o kahi maʻi polycystic a i ʻole amyloidosis i waena o nā kumu kūpono o CRF.

Hoʻohui ʻia, paipai ʻia kahi kūkā kamaʻilio maʻamau no nā pōpoki kiʻekiʻe me kāu kauka holoholona i kēlā me kēia makahiki a i ʻole i kēlā me kēia 6 mahina mai ka makahiki 7/8. ʻOiaʻiʻo, e hiki i kāu kauka holoholona ke hana i kahi loiloi piha i ke ʻano kikoʻī e nānā i ka hana maʻamau o nā puʻupaʻa a kau i kahi lāʻau i kahi e ʻike ʻia ka hoʻomaka o ka holomua.