Tele >> Aoga Soifua Maloloina >> O le a le nephrotic syndrome? Mafuaʻaga, faʻailoga, ma togafitiga

O le a le nephrotic syndrome? Mafuaʻaga, faʻailoga, ma togafitiga

Aoga Soifua Maloloina

E tele faʻamaʻi e fesoʻotaʻi ma le leaga le faʻatinoga o fatugaʻo. Afai e amata ona e maitauina o ou tapuvae ua fulafula, ua e niniva, pe i ai foi ni faʻalavelave e moe ai-e mafai ona faigata ona iloa pe aisea e le galue ai lou tino i le mea sili. Nei na o ni nai faʻailoga o fatugaʻo faʻaleagaina, ma e tele mafuaʻaga ono. O le faʻafitauli o le Nephrotic o se tasi na o faʻafitauli. O le a le nephrotic syndrome? Faitau pea e iloa mafuaʻaga, faʻailoga, ma togafitiga.

O le a le nephrotic syndrome?

Ne tupu le nephotic syndrome pe a le galue lelei le faʻamamaina o lou fatugao pei ona tatau ai. Lenei fatuga faʻaleagaina faʻatagaina protein masani ona maua i lou toto plasma e sasaʻa i urine. O le iʻuga ua tele naua porotini i lou miaga (proteinuria) ma laʻititi protein i lou toto. O le leiloa o polotini mai le toto e faʻatagaina ai le suavai e masani ona taofi e le polotini e oso i totonu o le tino, ma mafua ai le fulafula (e faʻaigoa foʻi o le edema).

O se matua seasea tulaga e aafia naʻo 5 i le 100,000 tagata taʻitoʻatasi , ae a le faʻatonutonuina, e mafai ona faʻaleagaina isi faiga tino a le tino. Faʻafitauli o nephrotic syndrome aofia ai faʻateleina lamatiaga o toto toto, maualuga kolisi, toto maualuga, anemia, ma aafia gofie i siama. Nimrotic syndrome e faʻavae-faʻavae i nisi tulaga, ae le o mea uma. Faʻatasi ai ma togafitiga talafeagai, e lelei le vavalo. A tuʻu le togafitia, e mafai ona oʻo ma mafua ai le paʻu fatu pe oti.

Mafuaʻaga

E i ai fuifui o toto laiti toto (taʻua o le glomeruli) i ou fatugaʻo e faʻamama lou toto a o pasia lenei totoga. Faʻaleagaina o le glomeruli o le sili ona masani ai mafuaʻaga o nephrotic syndrome. Ae ui i lea, e tele aiaiga e ono mafua ai glomerular faʻaleagaina, aofia ai:

Maʻi suka suka e faʻaigoaina o le suka suka nephropathy. E tusa kuata o tagata suka uma (uma Ituaiga 1 ma Ituaiga 2) mulimuli ane atiaʻe se fatugaʻo faʻamaʻi e mafai ona faʻaleagaina glomeruli.
Laʻititi suiga faʻamaʻi o le idiopathic syndrome, o lona uiga o le mafuaʻaga o le le masani ai gaioiga e le mafai ona fuafuaina. E maua lona igoa ona o le suiga i fatugaʻo e matua laʻititi latou e le mafai ona maitauina i se fatugaʻo biopsy. O le sili ona taatele mafuaʻaga o nephrotic syndrome i tamaiti, nafa ma le sili atu i le 90% o tamaiti faʻamaonia. Tele tamaiti e sili atu nai lo tamaʻi suiga faʻamaʻi, ae o nisi e faʻatatau ile matua. E tau le masani ai mo tagata matutua, aofia ai naʻo le 10% –15% o nephrotic syndrome mataupu. E ui lava o le mafuaʻaga e masani ona le iloa, e mafai ona faʻatupuina e siama viral, nonsteroidal anti-inflammatory vailaʻau (NSAIDs), tuma, ma isi tali faʻafitauli.
Glomerulosclerosis faʻatulagaina vaega (FSGS) o se alualu i luma faamaʻi e taulaʻi faapitoa, vaevaega vaega o le fatugaʻo. O tagata matutua uma e maua i le nephrotic syndrome, FSGS teugatupe mo 40% o latou . Mo tamaiti, FSGS tala mo 20% o mataupu. FSGS e mafai ona mafua mai i selesaito sela faʻamaʻi, faʻamaʻi, fesoʻotaʻiga o fualaʻau, lapoʻa, vailaʻau oona, ma (seasea) tuʻufaʻatasia genes le masani ai. Na taʻutaʻua e le aliʻi NBA o Alonzo Manoanoa le faʻamauina o fatugaʻo mo le FSGS, ma unaʻia ai o ia e litaea mai le liki i le 2003.
Nephropathy membrane muamua (PMN) faapitoa afaina ai le fatugaʻo glomeruli. A lava le protein e faʻamamaina i totonu o le miaga, e maua e tagata maʻi le faʻamaʻi o le nephrotic syndrome. E mafai ona tupu i uma tausaga, ae o le faʻamaʻi e sili atu ona faʻalauteleina i tagata taʻitoʻatasi 50-60. O se mautu 30% o tagata mamaʻi ma PMN mafai ona faʻaleleia o latou tulaga e aunoa ma se togafitiga poʻo le a lava. Peitai, le isi 30% i ai se alualu i luma tulaga o le a mulimuli ane manaʻomia dialysis po o se fatugaʻi tuiina. Mo i latou e leai se maʻi suka, o le PMN o le mafuaʻaga masani a le nephrotic syndrome i tagata matutua. E seasea tupu i tamaiti. O le PMN e mafua mai i faʻamaʻi o le autoimmune, faʻamaʻi pipisi, ma vailaʻau.
Systemic lupus erythematosus (SLE) o le ituaiga taatele o lupus. O se faʻamaʻi mumu masani e ono iʻu ai i le faʻaleagaina o fatugaʻo. O isi ituaiga o lupus e mafai foi ona avea ma etiological o nephrotic syndrome, pei o le lupus podocytopathy ma le lupus nephritis.
Amyloidosis e tupu pe a i ai le amyloid porotini fausiaina i se tagata maʻi totoga. O se protein e le masani ai ma e mafai ona fausia mai i tuʻufaʻatasiga eseese o polotini.

E tupu le nephotic syndrome i tamaiti ma tagata matutua, ae masani ona eseese mafuaaga. O tamaiti e foliga mai e maua ile faʻamaʻi i sina suiga ole faʻamaʻi. E masani ona maua e tagata matutua le faʻamaʻi nephrotic syndrome e mafua mai ile maʻi suka.

Tulaga lamatia

O nei faʻamaʻi uma e faʻaleagaina le faʻamama totoga i fatugaʻo o le tino. E le gata i lea, o loʻo i ai mea taua e faʻateleina ai le ono aʻafia o le nephrotic syndrome:

Faʻailoaina faʻafomaʻi: O maʻi sela sela, maʻi suka, kanesa ma le lupus e mafua ai ona maua oe ile nephrotic syndrome.
Vailaau: NSAIDs, tele vailaʻau, ma isi vailaʻau faʻateleina lamatiaga mo fatugaʻo faʻaleagaina. O le taumafaina o vailaʻau oona e mafai foi ona afaina ai fatugaʻo.
Pipisi: O le HIV, hepatitis B, hepatitis C, ma le malarial e faʻateleina ai le aʻafia o nephrotic syndrome.

O le suʻeina o au mea sa i ai muamua e mafai ona fesoasoani ia te oe e faʻamautinoa lelei ai pe oe ono aʻafia i le nephrotic syndrome. E le gata i lea, o le fuafuaina o le a le mafuaʻaga o le faʻaleagaina e mafai ona fesoasoani i le au tausi soifua maloloina sili atu ona togafitia o latou tagata mamaʻi.

Faʻailoga

E ui i eseʻese mafuaʻaga, e i ai le luʻitau o faʻailoga e mafai ona taʻitaʻia oe agai i se faʻailoga nephrotic syndrome. A e maua le tolu kalama o porotini i le miaga, faʻatasi ai ma le maualuga kolesterol, faʻaopopo le fula poʻo le edema, o lona uiga o le nephrotic syndrome e, faʻamatala. Ahmad Oussama Rifai, MD , o se nephrologist ma faʻapitoa maualuga o le toto maualuga falemaʻi ma faʻavae o le Virtual Nefrologist.

O faʻailoga taua e aofia ai:

Edema, poʻo le fula, aemaise lava o tapuvae, vae, foliga, ma le manava - ae mafai ona tupu i se isi mea o le tino
O le fefuli vai na mafua mai i le tele naua o polotini i miaga
Faatumauina o le suavai e mafua ai le maua o le mamafa
Le lavava
Leai o le fiaai
Maualuga le toto e mafua mai i lou tino taumafai e toe faʻafouina leiloa protein (pei o lipids poʻo anti-clotting polotini)
Faʻamaʻi soo
Paleni meaai

A faʻatasi nei faʻailoga ma le maualalo o le serum protein level ua taʻua o le albumin, o le isi lea faʻailoga taua mo nephrotic syndrome, e tusa ai Barry Gorlitsky, MD , nephrologist i Carolina Nephrology ma Pule Sili o KidneyAide.

O afea e valaʻau ai lau fomaʻi tausi soifua

Afai e te maitauina le tele o le mimi, pei o le foam mai le liligiina o se pia, pe poʻo le faʻateleina o le fulafula, ua oʻo i le taimi e vaai ai se fomaʻi, fai mai Dr. Gorlitsky. A e asiasi i se tausi soifua maloloina, o le a faʻatautaia e lau fomaʻi ni faʻataʻitaʻiga toto ma suʻega mimi (poʻo urinalysis).

Dr. Rifai faʻamatala atili e uiga i suʻega: Urinalysis o le sili ona taugofie suʻesuʻega i vailaʻau i le talafaʻasolopito o tagata ma le aofaʻi o faʻamatalaga na te avatua ia te oe. O le mea moni o se $ 0.07 suʻega e avatua ia oe ni vaega se 10 o faʻamatalaga, e aofia ai maʻi suka, polotini i le vai, toto i le vai, bilirubin, maʻi fatu, jaundice, vaivai maso. O le faʻamaʻi nefoti o se tasi faʻamaʻi e fesoasoani faʻataʻitaʻi le miaga e iloa ai. O lenei suʻega e mafai ona faia i le fale poʻo le ofisa o le fomaʻi.

O le biopsy fatugaʻo e mafai foi ona fesoasoani e iloa ai le mafuaʻaga mafuaʻaga i tua atu o ou faʻailoga. O le faʻamaoniga e mafai ona avea ma se faʻalavelave faigata pe a le lava se fatugaʻo biopsy maua ai faʻamatalaga, poʻo iʻuga i le malamalama microscopy (pe a le mafai ona vaʻaia se mea o le maitauga i se biopsy masani). Ona faʻamatala lea e Dr. Rafai e ono faia e se fomaʻi ni pisipisia faʻapitoa, electron microscopy, poʻo le microscopy puipuia. Faʻavae i luga o lena, o le a tatou filifili poʻo le a le etiology ma pe faʻafefea ona togafitia lenei, Dr. Rifai fai mai.

Afai e te mauaina se faʻamaoniga o sina suiga o faʻamaʻi mai le tasi biopsy, oe ono manaʻo e talosagaina se lona lua biopsy mai se isi vaega o le fatugaʻo. E mafua ona o le FSGS (o le faʻapitoa ma vaega, pei ona taʻu mai e le igoa) tupu i nisi vaega o le fatugaʻo, ae le o isi.

Ua faatusaina e Dr. Rifai le fatugao i se togalaau, atonu e eseese vaega o togavao, fugalaʻau ma laʻau. Na ia faʻaopopo mai, Afai ua e le laki e ave se biopsy mai se masani fatugaʻo vaega, ona e faʻaigoaina o se laʻititi suiga faʻamaʻi ae o le mea moni FSGS. Talu ai o le FSGS e alualu i luma, o lenei e mafai ona faʻamaonia le mataʻutia.

FUAFUA: Creatinine tofotofoga, masani faasologa, ma le auala e tuu i lalo tulaga

Faʻafefea ona pulea nephrotic syndrome

Soʻo se tagata lava e maua i le nephrotic syndrome e eseese, ae talu ai e tele mafuaʻaga, e tele togafitiga ono.

Vitamini D: O lenei mea aoga e fesoasoani e faʻatonutonu ai le galue o fatugaʻo. E masani ona faʻaaoga e tagata maʻi o le nephotic syndrome le vitamini D faʻaopopo, faʻaopopo i mea masani, e fesoasoani ai ia latou togafitiga.
Suiga o taumafataga: E masani ona fautuaina e fomaʻi ia fetuʻunaʻiga o meaʻai e faʻaititia ai le polotini i le mimi ma isi vai. Ae maise lava, tagata gasegase mafai ona o i luga o le maualalo-sodium taumafa (masani lava ona laʻititi ifo i le 1,000 mg o le sodium i le aso) faʻapea foi ma le faʻaititia o le faʻaaogaina o polotini. E lelei foʻi le faʻatapulaʻa le taumafaina o gaʻo gaʻo.

FUAFUA: Maualuga togafitiga triglyceride filifiliga

Vailaau: E tele ituaiga vailaʻau e ono faatonuina e lau fomaʻi, faʻamoemoe i mafuaʻaga autu o au faʻailoga.

Steroids e fesoasoani faʻaititia le fatugaʻo glomeruli pupuga
Faʻataʻitaʻiga faiga fesoasoani e fesoasoani ai i le faʻasaʻo o faʻafitauli o le metabolic, pei o lupus poʻo vailaʻau o le suka
Angiotensin-liua o le enzyme (ACE) mea faʻapipiʻi e faʻaititia ai le toto maualuga
Diuretics, poʻo fualaʻau vai, e faʻaititia ai le taofiofia o le vai ma le fulafula
Toto manifinifi, poʻo anticoagulants, e faʻaititia ai le aʻafiaga o le faʻaputuputu

E naʻo nai fualaʻau faʻapitoa faʻapitoa mo nephrotic syndrome. Tele o nei vailaʻau o loʻo faʻaaogaina-igoa e faʻaitiitia ai faʻailoga o le tulaga.

Vailaau e togafitia nephrotic syndrome
Igoa fualaʻau	Vasega fualaʻau	Faʻafefea ona galue	Maua se coupon
Prinivil, Qbrelis, Zestril (lisinopril)	Aisa taofi	Faʻaitiitia le toto	Maua se coupon
Lotensin (benazepril)	Aisa taofi	Faʻaitiitia le toto	Maua se coupon
Vasotec (captopril / enalapril)	Aisa taofi	Faʻaitiitia le toto	Maua se coupon
Lasix (furosemide)	Diuretics	Faʻaitiitia le taofiofia o vai e faʻaititia ai le fulafula	Maua se coupon
Aldactone, Carospir (spironolactone)	Tagata tetee tetee	Faʻaitiitia le taofiofia o vai e faʻaititia ai le fulafula	Maua se coupon
Zaroxolyn (hydrochlorothiazide poʻo metolazone)	Thiazides	Faʻaitiitia le taofiofia o vai e faʻaititia ai le fulafula	Maua se coupon
Lipitor (atorvastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Lescol XL (fluvastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Altoprev (lovastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Pravachol(pravastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Crestor(rosuvastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Zocor(simvastatin)	HMG-CoA mea faʻatapulaʻa (statins)	Faʻaitiitia le suka	Maua se coupon
Jantoven(warfarin)	Anetikerisi	Faʻaitiitia lamatiaga toto	Maua se coupon
Pradaxa(dabigatran)	Taui sao thrombin	Faʻaitiitia lamatiaga toto	Maua se coupon
Eliquis(apixaban)	Vaega Xa taofi	Faʻaitiitia lamatiaga toto	Maua se coupon
Xarelto(rivaroxaban)	Vaega Xa taofi	Faʻaitiitia lamatiaga toto	Maua se coupon
Rituxan(rituximab)	Monoclonal sela	Faʻaitiitia vailaʻau leaga e mafua ai le fulafula	Maua se coupon
Prednisolone(prednisone)	Corticosteroids	Faʻaosoina le faʻamagaloina e ala i le foʻia o proteinuria	Maua se coupon

Tusa lava pe o ou faʻailoga e lelei ona faʻatautaia e meaʻai, mea faʻaopopo, ma vailaʻau, e tatau lava ona e mataala mo faʻailoga ile lumanaʻi. Fai mai Dr. Gorlitsky, O le tele o taimi matou te faʻaauau ona vaʻavaʻaia taimi uma ina ia mautinoa e leai ni afi. E maua ai e tagata mamaʻi ma latou 'au fomaʻi le avanoa e faʻatautaia ai na mea pe a o mai.