Hemodialysis

I loko o ka hemodialysis, hoʻomaʻemaʻe ka mīkini i nā ʻōpala, nā paʻakai a me ka wai mai kou koko ke ʻaʻole i lawa ka olakino o kou mau puʻupaʻa e hana pono ai i kēia hana. ʻO ka Hemodialysis (he-moe-die-AL-uh-sis) kekahi ala e mālama ai i ka hōʻino nui ʻana o nā puʻupaʻa a hiki ke kōkua iā ʻoe e hoʻomau i kahi ola ikaika me ka nānā ʻole i ka hōʻino ʻana o nā puʻupaʻa.

E kōkua kāu kauka e hoʻoholo i ka manawa e hoʻomaka ai ʻoe i ka hemodialysis ma muli o kekahi mau mea, me kāu: Ola kino holoʻokoʻa Hana o ka puʻupaʻa Nā hōʻailona a me nā hōʻailona Maikaʻi o ke ola Makemake pilikino Loaʻa paha iā ʻoe nā hōʻailona a me nā hōʻailona o ka hāʻule ʻana o ka puʻupaʻa (uremia), e like me ka luhi, ka luaʻi, ka pehu a i ʻole ka luhi. Hoʻohana kāu kauka i kāu helu glomerular filtration rate (eGFR) i helu ʻia e ana i ke kiʻekiʻe o ka hana o kāu puʻupaʻa. Hoʻomaulia ʻia kāu eGFR me ka hoʻohana ʻana i nā hopena o kāu hoʻokolohua koko creatinine, kāne, makahiki a me nā mea ʻē aʻe. He ʻokoʻa ka waiwai maʻamau me ka makahiki. Hiki i kēia ana o ka hana o kāu puʻupaʻa ke kōkua i ka hoʻolālā ʻana i kāu mālama ʻana, me ka manawa e hoʻomaka ai i ka hemodialysis. Hiki i ka hemodialysis ke kōkua i kou kino e kaohi i ke koko a mālama i ke kaulike kūpono o ka wai a me nā minelala like ʻole - e like me ka potassium a me ka sodium - i loko o kou kino. Ma ke ʻano maʻamau, hoʻomaka ka hemodialysis ma mua loa o ka pani ʻana o kāu puʻupaʻa i kahi e hiki ai ke hoʻopilikia i ke ola. ʻO nā kumu maʻamau o ka hāʻule ʻana o ka puʻupaʻa: Maʻi suka Ke koko kiʻekiʻe (hypertension) ʻO ka mumū o ka puʻupaʻa (glomerulonephritis) Nā cysts puʻupaʻa (polycystic kidney disease) Nā maʻi puʻupaʻa hoʻoilina Hoʻohana lōʻihi o nā lāʻau anti-inflammatory nonsteroidal a i ʻole nā ​​lāʻau ʻē aʻe e hiki ke hōʻino i nā puʻupaʻa Akā naʻe, hiki i kāu puʻupaʻa ke pani koke (acute kidney injury) ma hope o ka maʻi nui, ka ʻoki paʻakikī, ka puʻuwai a i ʻole ka pilikia nui ʻē aʻe. Hiki i kekahi mau lāʻau ke hoʻopilikia i ka puʻupaʻa. Hiki i kekahi poʻe me ka hāʻule ʻana o ka puʻupaʻa lōʻihi (maʻi) ke hoʻoholo ʻole e hoʻomaka i ka dialysis a koho i kahi ala ʻē aʻe. Ma kahi o kēlā, hiki iā lākou ke koho i ka mālama lapaʻau nui loa, i kapa ʻia hoʻi ʻo ka mālama mālama nui loa a i ʻole ka mālama palliative. Hoʻopili kēia mālama i ka hoʻokele ikaika o nā pilikia o ka maʻi puʻupaʻa maʻi lōʻihi, e like me ka wai nui, ke koko kiʻekiʻe a me ka anemia, me ka nānā ʻana i ka mālama kākoʻo o nā hōʻailona e hoʻopilikia i ka maikaʻi o ke ola. Hiki i nā poʻe ʻē aʻe ke lilo i mau moho no ka hoʻololi puʻupaʻa preemptive, ma kahi o ka hoʻomaka ʻana i ka dialysis. E noi i kāu hui mālama ola no ka ʻike hou aku e pili ana i kāu mau koho. He hoʻoholo pilikino kēia no ka mea hiki ke ʻokoʻa nā pono o ka dialysis, ma muli o kāu mau pilikia olakino kūikawā.

ʻO ka hapa nui o nā kānaka e pono ai ka hemodialysis he mau pilikia olakino like ʻole. Hoʻolōʻihi ka hemodialysis i ke ola no nā kānaka he nui, akā ʻo ka lōʻihi o ke ola no nā kānaka e pono ai ia, ʻoi aku ka pōkole ma mua o ka heluna kanaka maʻamau. ʻOiai hiki i ka mālama hemodialysis ke hoʻololi pono i kekahi hana o ka puʻupaʻa i nalowale, hiki iā ʻoe ke ʻike i kekahi o nā kūlana pili i helu ʻia ma lalo nei, ʻaʻole naʻe e ʻike nā kānaka a pau i kēia mau pilikia a pau. Hiki i kāu hui dialysis ke kōkua iā ʻoe e mālama iā lākou. Ka haʻahaʻa o ke koko (hypotension). ʻO ka emi ʻana o ke kaomi koko ka hopena maʻamau o ka hemodialysis. Hiki ke hele pū ka haʻahaʻa o ke kaomi koko me ka hanu pōkole, nā ʻeha ʻōpū, nā ʻeha o nā ʻiʻo, ka luaʻi a i ʻole ka luaʻi. ʻO nā ʻeha o nā ʻiʻo. ʻOiai ʻaʻole maopopo ke kumu, he mea maʻamau nā ʻeha o nā ʻiʻo i ka wā o ka hemodialysis. I kekahi manawa, hiki ke hoʻomaha i nā ʻeha ma ka hoʻoponopono ʻana i ka palapala hemodialysis. ʻO ka hoʻoponopono ʻana i ka wai a me ka sodium i waena o nā mālama hemodialysis hiki nō hoʻi ke kōkua i ka pale ʻana i nā hōʻailona i ka wā o nā mālama. Ke ʻili ʻili. He nui nā kānaka e hele nei i ka hemodialysis he ʻili ʻili, ʻoi aku ka nui i ka wā a i ʻole ma hope koke o ke kaʻina hana. Nā pilikia hiamoe. He nui nā kānaka e loaʻa ana i ka hemodialysis i ka pilikia hiamoe, i kekahi manawa ma muli o nā haki i ka hanu i ka wā hiamoe (sleep apnea) a i ʻole ma muli o ka ʻeha, ka ʻoluʻolu ʻole a i ʻole nā ​​wāwae hoʻomaha ʻole. Anemia. ʻO ka nele i nā pūnaewele ʻulaʻula lawa i loko o kou koko (anemia) kahi pilikia maʻamau o ka hāʻule ʻana o ka puʻupaʻa a me ka hemodialysis. Hoʻemi ka puʻupaʻa hāʻule i ka hana ʻana i ka hormone i kapa ʻia ʻo erythropoietin (uh-rith-roe-POI-uh-tin), ka mea e hoʻoulu ai i ka hana ʻana o nā pūnaewele ʻulaʻula. Hiki i nā palena ʻai, ka ʻilihune o ka hoʻomoʻi ʻana o ka hao, nā hoʻokolohua koko pinepine, a i ʻole ka wehe ʻana o ka hao a me nā wikamina e ka hemodialysis ke kōkua pū i ka anemia. Nā maʻi iwi. Inā ʻaʻole hiki i kāu puʻupaʻa i hōʻino ʻia ke hoʻomaʻamaʻa i ka wikamina D, ka mea e kōkua ai iā ʻoe e hoʻomoʻi i ka calcium, hiki ke nāwaliwali kou mau iwi. Eia kekahi, hiki i ka nui o ka parathyroid hormone - kahi pilikia maʻamau o ka hāʻule ʻana o ka puʻupaʻa - ke hoʻokuʻu i ka calcium mai kou mau iwi. Hiki i ka hemodialysis ke hoʻopilikia i kēia mau kūlana ma ka wehe ʻana i ka nui a i ʻole ka liʻiliʻi o ka calcium. Ke koko kiʻekiʻe (hypertension). Inā ʻoe e ʻai nui i ka paʻakai a inu nui i ka wai, e ʻoi aku ka nui o kou koko kiʻekiʻe a alakaʻi i nā pilikia naʻau a i ʻole nā ​​stroke. Ka nui o ka wai. ʻOiai ua lawe ʻia ka wai mai kou kino i ka wā o ka hemodialysis, hiki i ka inu ʻana i ka wai nui ma mua o ka mea i ʻōlelo ʻia ma waena o nā mālama hemodialysis ke hoʻokumu i nā pilikia weliweli i ke ola, e like me ka hāʻule ʻana o ka naʻau a i ʻole ka hōʻiliʻili ʻana o ka wai i loko o kou mau māmā (pulmonary edema). Ka mumū o ka membrane e hoʻopuni ana i ka naʻau (pericarditis). Hiki i ka hemodialysis lawa ʻole ke alakaʻi i ka mumū o ka membrane e hoʻopuni ana i kou naʻau, ka mea hiki ke hoʻopilikia i ka hiki o kou naʻau ke puʻunaue i ke koko i ke koena o kou kino. Nā kiʻekiʻe o ka potassium (hyperkalemia) a i ʻole nā ​​kiʻekiʻe haʻahaʻa o ka potassium (hypokalemia). Hoʻoneʻe ka hemodialysis i ka potassium keu, ʻo ia kahi minelala i wehe ʻia mai kou kino e kou mau puʻupaʻa. Inā nui a liʻiliʻi paha ka potassium i wehe ʻia i ka wā dialysis, hiki i kou naʻau ke pā ʻole a kū paha. Nā pilikia o ka wahi komo. Hiki i nā pilikia weliweli - e like me ka maʻi, ka hoʻonui ʻana a i ʻole ka pupuhi ʻana o ka paia o ke kīʻaha koko (aneurysm), a i ʻole ka palahalaha - ke hoʻopilikia i ka maikaʻi o kāu hemodialysis. E hahai i nā ʻōlelo a kāu hui dialysis pehea e nānā ai i nā loli i kāu wahi komo e hōʻike ana i kahi pilikia. Amyloidosis. Hoʻomohala ʻia ka dialysis-related amyloidosis (am-uh-loi-DO-sis) i ka wā e waiho ʻia ai nā protein i loko o ke koko ma nā hui a me nā tendons, e hoʻokumu ana i ka ʻeha, ka paʻakikī a me ka wai i loko o nā hui. ʻOi aku ka maʻamau o ke kūlana i nā kānaka i hele i ka hemodialysis no nā makahiki he nui. Kaumaha. He mea maʻamau nā loli i ke ʻano i nā kānaka me ka hāʻule ʻana o ka puʻupaʻa. Inā ʻoe e ʻike i ka kaumaha a i ʻole ka hopohopo ma hope o ka hoʻomaka ʻana o ka hemodialysis, e kamaʻilio me kāu hui mālama ola e pili ana i nā koho mālama pono.

Hoʻomākaukau no ka hemodialysis e hoʻomaka ana i mau pule a mau mahina ma mua o kāu hana mua. No ka maʻalahi o ke komo ʻana i kou kahe koko, e hana kahi kauka i kahi komo vascular. Hāʻawi ka komo ʻana i kahi ala no kahi liʻiliʻi o ke koko e lawe maluhia ʻia mai kou kahe koko a laila hoʻihoʻi ʻia iā ʻoe i mea e hana ai ke kaʻina hana hemodialysis. Pono ka komo ʻana i ka ʻoki kino i ka manawa e ho'ōla ai ma mua o kou hoʻomaka ʻana i nā lāʻau hemodialysis. Aia he ʻekolu ʻano o nā komo: Arteriovenous (AV) fistula. ʻO kahi AV fistula i hana ʻia ma ke ʻoki kino he pilina ia ma waena o kahi artery a me kahi vein, maʻamau ma ka lima āu e hoʻohana pinepine ʻole ai. ʻO kēia ke ʻano komo i makemake ʻia ma muli o ka pono a me ka palekana. AV graft. Inā liʻiliʻi loa kāu mau kīʻaha koko e hana i kahi AV fistula, hiki i ke kauka ke hana i kahi ala ma waena o kahi artery a me kahi vein me ka hoʻohana ʻana i kahi paipu synthetic flexible i kapa ʻia he graft. Central venous catheter. Inā pono ʻoe i ka hemodialysis pilikia, hiki ke hoʻokomo ʻia kahi paipu plastik (catheter) i loko o kahi vein nui ma kou ʻāʻī. He manawa wale nō ke catheter. He mea nui loa ia e mālama pono i kou wahi komo e hoʻemi ai i ka hiki ke maʻi a me nā pilikia ʻē aʻe. E hahai i nā ʻōlelo a kāu hui mālama ola e pili ana i ka mālama ʻana i kou wahi komo.

Hiki iā ʻoe ke loaʻa ka hemodialysis ma kahi kikowaena dialysis, ma ka home a i ʻole ma ka haukapila. Hoʻololi ka pinepine o ka mālama ʻana, ma muli o kou kūlana: Hemodialysis ma ke kikowaena. Loaʻa i nā kānaka he nui ka hemodialysis ʻekolu manawa i ka hebedoma i nā hālāwai o 3 a 5 mau hola. Hemodialysis i kēlā me kēia lā. Hoʻopili kēia i nā hālāwai pinepine, akā pōkole - maʻamau i hana ʻia ma ka home ʻeono a ʻehiku paha lā i ka hebedoma no kahi o ʻelua hola i kēlā me kēia manawa. Ua lilo nā mīkini hemodialysis maʻalahi i ka hemodialysis home ʻaʻole i pilikia nui, no laila me ka hoʻomaʻamaʻa kūikawā a me kekahi e kōkua iā ʻoe, hiki paha iā ʻoe ke hana i ka hemodialysis ma ka home. Hiki paha iā ʻoe ke hana i ke kaʻina hana i ka pō i kou hiamoe ʻana. Aia nā kikowaena dialysis ma ʻAmelika Hui Pū ʻIa a ma kekahi mau ʻāina ʻē aʻe, no laila hiki iā ʻoe ke hele i nā wahi he nui a loaʻa nō hoʻi kāu hemodialysis ma ka papa manawa. Hiki i kāu hui dialysis ke kōkua iā ʻoe e hana i nā ʻaha kūkā ma nā wahi ʻē aʻe, a i ʻole hiki iā ʻoe ke hoʻokaʻaʻike pololei i ke kikowaena dialysis ma kou wahi e hele ai. Hoʻolālā i mua e hōʻoia i ka loaʻa o kahi a hiki ke hana ʻia nā hoʻonohonoho kūpono.