Weronga Whatukuhu, Koi

Ka tangohia e ngā whatukuhu te paru me te wai tāpiri mai i te toto mā ngā wāhanga tākai e kiia nei ko ngā nephron. Kei roto i ia nephron tētahi tākai, e kiia nei ko te glomerulus. Kei roto i ia tākai ngā oko toto iti e kiia nei ko ngā capillary. Ka rere te toto ki roto ki tētahi glomerulus, ka pā atu ngā pūngāwerewere iti, e kiia nei ko ngā molecules, o te wai, ngā kohuke me ngā kai, me ngā paru, mā ngā pakitara capillary. Kāore ngā molecules nui, pēnei i ngā pūngāwerewere me ngā pū toto whero. Ko te wāhanga i tākaihia ka pā atu ki tētahi atu wāhanga o te nephron e kiia nei ko te tubule. Ka tukuna te wai, ngā kai me ngā kohuke e hiahiatia ana e te tinana ki te rerenga toto. Ko te wai tāpiri me te paru ka waiho hei mimi ka rere ki te pūngāwerewere.

Ka puta te whara whatukuhu ohorere ina kore e taea e ngā whatukuhu te tākai i ngā hua paru mai i te toto. Ki te kore e taea e ngā whatukuhu te tākai i ngā paru, ka nui haere pea ngā taumata kino o ngā paru. Ka rere pea te hanganga matū o te toto.

I mua, i kiia te whara whatukuhu ohorere ko te korenga o te whatukuhu. Ko te whara whatukuhu ohorere te tino noa i roto i te hunga kei te hōhipera, te nuinga i roto i te hunga e hiahia ana ki te tiaki matatau.

Ka rereke te whara whatukuhu ohorere mai i te ngawari ki te kino. Ki te kino, haere tonu, ā, kore e rongoā, ka mate pea. Engari ka taea hoki te whakahoki. Ka taea e te hunga kei te hauora pai te whakahoki mai i te whakamahinga noa, ā, tata noa ki te whakamahinga noa o ō rātou whatukuhu.

Ngā tohu o te whākōaretanga whatukuhu ohorere ka uru atu ki:

• He iti te putanga mimi.
• Te kohinga wai, ka taea te whakaeke manawa me te pupuhi i ngā waewae, ngā turi, ngā waewae rānei.
• Te ngenge.
• Te whakapohehe, te ngaro rānei o te hinengaro.
• Te ruaki.
• Te mamae i te kopu, i te taha rānei i raro i te kauae rīwai.
• Te ngoikore.
• Te tukituki o te ngakau.
• Te kōrerotanga.
• Te ngaro o te hiahia kai.
• Ngā hopu, te koma rānei i ngā keehi kino.

I etahi wā, kāore ngā tohu e puta mai i te whākōaretanga whatukuhu ohorere. Katahi ka kitea pea mā ngā whakamātautau taiwhanga i mahia mō tētahi atu mea.

Tena waea atu ki tō kaiāwhina hauora mā te tere, ki te rapu rānei i te tiaki āwhina, ki te pēhea rānei ngā tohu o te whara whatukuhu ohorere.

Ka taea te whara o te whatukuhu koi ina:

• Kei a koe tetahi āhuatanga e whakaiti ana i te rere o te toto ki ō whatukuhu.
• Kei a koe tetahi kino ki ō whatukuhu.
• Ka aukatitia ngā tūpū wai mimi o ō whatukuhu, e kiia nei ko ngā ureters.

Ngā āhuatanga ka whakaiti pea i te rere o te toto ki ngā whatukuhu, ā, ka āwhina ki te whara o te whatukuhu:

• Te ngaro o te wai tinana nui rawa atu, e kiia nei ko te mate wai.
• Te mate pukupuku me te kore ranei o te mate sepsis, te mate pukupuku septic ranei.
• Ngā rongoā penei i te aspirin, te ibuprofen (Advil, Motrin IB, ētahi atu) te naproxen sodium ranei (Aleve).
• Te ngaro o te toto, te wai ranei.
• Te mate ngākau.
• Te korenga o te ngākau, te mate ngākau ranei.
• Te mate cirrhosis o te ate, te korenga ranei.
• Te mate pāwera kino, e kiia nei ko te anaphylaxis.
• Ngā tahuna kino.

Ko ēnei e whai ake nei ka kino pea ngā whatukuhu, ā, ka āwhina ki te whara o te whatukuhu koi:

• Te pupuhi me te mamae, e kiia nei ko te mumura, o ngā kākahu iti i roto i ngā whatukuhu. E kiia ana tēnei ko te glomerulonephritis (gloe-mer-u-loe-nuh-FRY-tis).
• Ngā rongoā, penei i ētahi rongoā chemotherapy, ngā rongoā mate pukupuku me ngā tae e whakamahia ana i ngā whakamātautau whakaahua.
• Te mate pukupuku, penei i te huaketo e pā ana ki te mate coronavirus 2019 (COVID-19).
• Ngā poizon, penei i te waipiro, ngā konganuku taimaha me te cocaine.
• Tetahi āhuatanga pūnaha ārai e kiia nei ko te lupus e pā ana ki te glomerulonephritis.
• Ngā toto toto i roto i ngā uaua me ngā āti i roto, me te taha o ngā whatukuhu.
• Ngā tāpiringa cholesterol e aukati ana i te rere o te toto i roto i ngā whatukuhu.
• Tetahi āhuatanga e puta mai ana i te whakangaromia o ngā pūtau toto whero i mua rawa atu, e kiia nei ko te mate uremic hemolytic.
• Tetahi rōpū o ngā mate onge e pā ana ki te kiri me ngā kiko hono e kiia nei ko te scleroderma.
• Tetahi mate toto onge e kiia nei ko te thrombotic thrombocytopenic purpura.
• Te pakaru o ngā kiko uaua, e kiia nei ko te rhabdomyolysis. Ko ngā poizon mai i te whakangaromia o te uaua ka āwhina ki te kino o te whatukuhu.
• Te pakaru o ngā pūtau mate pukupuku e kiia nei ko te mate lysis pukupuku. Ka āwhina tēnei ki te tuku i ngā poizon ka kino pea ngā whatukuhu.

Ngā āhuatanga e pupuri ana i te mimi kei te haere atu i te tinana e kiia ana ko te aukatinga mimi. Ka āwhina ēnei ki te whara o te whatukuhu koi. Kei roto i ēnei:

• Ngā kōhatu whatukuhu.
• Te pupuhi o te prostate.
• Ngā toto toto i roto i te ara mimi.
• Te mate pukupuku o te putea mimi.
• Te mate pukupuku o te prostate.
• Te mate pukupuku o te cervix.
• Te mate pukupuku o te kōroa.
• Te tipu e pēhi ana ki ngā ureters.
• Te kino o ngā io e whakahaere ana i te putea mimi.

Ko te whākōhinga o te whatukuhu tata ki te kore e hono atu ki tetahi atu āhuatanga hauora, kaua rānei. Ko ngā āhuatanga ka taea te whakapiki ake i tō tūponotanga ki te whākōhinga o te whatukuhu e whai ake nei:

• Te mate whatukuhu haere tonu, e kiia ana hoki ko te mate whatukuhu roa.
• Te pakeketanga, engari ka puta ki ngā tamariki.
• Te noho i te whare hauora, te nuinga o te wā mō te āhuatanga kino e hiahia ana ki te tiaki matatau.
• Ngā aukati i ngā oko toto i ō ringa, i ō waewae rānei, e kiia ana ko te mate oko toto o te taha.
• Te mate huka, ina koa ki te kore e whakahaeretia.
• Te korenga o te ngakau.
• Ngā mate ate.
• Ngā kēnē āhua, me ā rātou maimoatanga.

Ngā raruraru pea o te whākōkī whatumanawa ohorere ka uru atu ki:

• Te kōkī o te wai. Ko te kōkī o te wai ki roto ki ō ringaringa ka pā te poto o te manawa.
• Te mamae o te uma. Ka mumura pea te papanga e hipoki ana i tō ngakau, e kiia nei ko te pericardium. Ka pā pea te mamae o te uma.
• Te ngoikore o te uaua. Ka puta pea tenei i te koretake o ngā wai o te tinana me ngā kohuke i roto i te toto, e kiia nei ko ngā electrolytes.
• Te pakaru tonu o te whatumanawa. I etahi wā, ka pā te ngaro o te whatumanawa mō te ora katoa i te whākōkī whatumanawa ohorere, e kiia nei ko te mate whatumanawa mutunga. Ko te hunga e pangia ana e te mate whatumanawa mutunga ka hiahia rātou ki ngā maimoatanga ora katoa hei tango i ngā paru i roto i te tinana, e kiia nei ko te dialysis, kāore rānei he whakawhiti whatumanawa hei ora.

Ka taea e koe te whakaiti i tō tūponotanga ki te whara o te whatukuhu koi mā te tiaki i ō whatukuhu. Whakamātauria te:

• Whakawātea tere mō ngā mate kino.
• Ora hauora. Kia kaha, kai kai hauora, tōtika. Ki te inu koe i te waiū, inu noa i te nui tika. Ki te whai koe i ngā take tūponotanga mō te mate whatukuhu, tirohia tō rōpū hauora kia tino tika ngā rongoā tākuto e inu ana koe mō ō whatukuhu.

I te wā o te tātaritanga whatukuhu, ka whakamahi tetahi kaimahi hauora i te ngira hei tango i te tauira iti o te kiko whatukuhu mō te whakamātautau taiwhanga. Ka whakatōngia te ngira tātaritanga i roto i te kiri ki te whatukuhu. I te nuinga o te wā, ka whakamahia tētahi taputapu whakaahua, pēnei i te transducer ultrasound, hei aratohu i te ngira.

Āta kōwhiria ēnei whakamātautau hei whakatau i te whara whatukuhu ohorere:

• Ngā whakamātautau toto. Ka taea e te tauira o tō toto te whakaatu i ngā taumata tere-ara o te urea me te creatinine. Ka āwhina tēnei ki te whakaatu me pēhea te mahi o ō whatukuhu.
• Ngā ine o te putanga mimi. Ko te ine i te nui o te mimi e tukuna ana e koe i roto i te 24 haora ka āwhina pea ki te kimi i te take o tō ngoikore whatukuhu.
• Ngā whakamātautau mimi. Ka taea e te tauira o tō mimi te whakaatu i tētahi mea e kī ana i tētahi āhuatanga ka taea te whakamārama i te ngoikore whatukuhu. Ka kiia tēnei ko te urinalysis.
• Ngā whakamātautau whakaahua. Ka taea e ngā whakamātautau whakaahua pēnei i te ultrasound me ngā karapa CT te whakaatu i ō whatukuhu.
• Tango i te tauira o te kiko whatukuhu mō te whakamātautau. Ka taea e tō kaimahi hauora te kī ki te tango i te tauira iti o te kiko whatukuhu mō te whakamātautau taiwhanga. Ka kiia tēnei ko te tātaritanga. Ka tangohia te tauira e te ngira e whakatōngia ana i roto i tō kiri ki roto i tō whatukuhu.

Ko te rongoā mō te whākōaretanga o te whatukuhu i te wā poto, ko te nuinga o te wā ka noho i te whare hauora. Ko te nuinga o te hunga e pangia ana e te whākōaretanga o te whatukuhu i te wā poto kei te whare hauora kē. Ko te roa o tō noho i te whare hauora ka whakawhirinaki ki te take o tō whākōaretanga o te whatukuhu i te wā poto, me te tere o te ora o ō whatukuhu.

Ko te rongoā mō te whākōaretanga o te whatukuhu i te wā poto, ko te kimi i te mate, te whara rānei i pā ki ō whatukuhu. Ko tō rongoā ka whakawhirinaki ki te take. Ka āhei pea te mutu i te rongoā e pāngia ana ō whatukuhu.

Ka mahi tahi hoki tō rōpū hauora ki te aukati i ngā raruraru me te hoatu i te wā ki ō whatukuhu kia ora. Ko ngā rongoā hei āwhina i te aukati i ngā raruraru:

• Ngā rongoā hei whakataurite i ngā wai i roto i tō toto. Ki te koretake o ngā wai i roto i tō toto te take o tō whākōaretanga o te whatukuhu i te wā poto, ka hiahia pea koe ki ngā wai mā te uaua, e kiia nei ko ngā wai intravenous (IV).

Ki te pā te whākōaretanga o te whatukuhu i te wā poto ki a koe kia nui rawa te wai, ka āhei pea te pupuhi o ō ringa me ō waewae. Katahi ka hiahia pea koe ki ngā rongoā e kiia nei ko ngā diuretics, e pāngia ana e tō tinana te whakakore i ngā wai nui.

• Te rongoā hei tango i ngā poihana i roto i tō toto. Ki te hanga ngā paru i roto i tō toto, ka hiahia pea koe ki te hemodialysis mō tētahi wā. E kiia ana hoki ko te dialysis, ka āwhina i te tango i ngā poihana me ngā wai nui i roto i tō tinana i te wā e ora ana ō whatukuhu.

Ka āhei pea te āwhina a te Dialysis ki te tango i te pāhare pāhare nui i roto i tō tinana. I te wā o te dialysis, ka pupuhi tētahi mīhini i te toto i waho o tō tinana mā tētahi whatukuhu mahi, e kiia nei ko te dialyzer, e tārai ana i ngā paru. Katahi ka whakahokia te toto ki tō tinana.

Ngā rongoā hei whakataurite i ngā wai i roto i tō toto. Ki te koretake o ngā wai i roto i tō toto te take o tō whākōaretanga o te whatukuhu i te wā poto, ka hiahia pea koe ki ngā wai mā te uaua, e kiia nei ko ngā wai intravenous (IV).

Ki te pā te whākōaretanga o te whatukuhu i te wā poto ki a koe kia nui rawa te wai, ka āhei pea te pupuhi o ō ringa me ō waewae. Katahi ka hiahia pea koe ki ngā rongoā e kiia nei ko ngā diuretics, e pāngia ana e tō tinana te whakakore i ngā wai nui.

Ka hiahia pea koe ki ngā rongoā e kiia nei ko ngā kaihōpara pāhare pāhare hei ārai i te hanga o te pāhare pāhare. Kei roto i ēnei ko te sodium zirconium cyclosilicate (Lokelma) te patiromer rānei (Veltassa). Ko te pāhare pāhare nui rawa atu i roto i te toto ka pāngia e ngā whiu ngākau koretake, e kiia nei ko ngā arrhythmias, me te ngoikore o ngā uaua.

Te rongoā hei tango i ngā poihana i roto i tō toto. Ki te hanga ngā paru i roto i tō toto, ka hiahia pea koe ki te hemodialysis mō tētahi wā. E kiia ana hoki ko te dialysis, ka āwhina i te tango i ngā poihana me ngā wai nui i roto i tō tinana i te wā e ora ana ō whatukuhu.

Ka āhei pea te āwhina a te Dialysis ki te tango i te pāhare pāhare nui i roto i tō tinana. I te wā o te dialysis, ka pupuhi tētahi mīhini i te toto i waho o tō tinana mā tētahi whatukuhu mahi, e kiia nei ko te dialyzer, e tārai ana i ngā paru. Katahi ka whakahokia te toto ki tō tinana.

I te wā e hoki ora ana koe i te whākōaretanga whatukuhu ohorere, ka taea e te kai motuhake te tautoko i ō whatukuhu me te whakaiti i te mahi e meinga ana e rātou. Ka tono pea tō rōpū hauora ki te kaiwhakauru kai. Ka taea e te kaiwhakauru kai te titiro ki ngā mea e kai ana koe, ā, ka whakaaro ki ngā huarahi hei whakangāwari i tō kai mō ō whatukuhu.

Ka kī pea tō kaiwhakauru kai kia:

• Kōwhiri kai iti ake te pāhare pāporo. Kei roto i ēnei ngā ăporo, ngā pīki, ngā kāreti, ngā pīni kākāriki me te taro mā, me te raihi mā. Kai i ēnei i te wāhi o ngā kai nui ake te pāhare pāporo. Kei roto i ēnei ngā pūrua, ngā panana, ngā tamati, ngā moko, ngā pīni me ngā nati.
• Kaua e kai i ngā kai kua tāpirihia te tote. Kei roto i ēnei ngā kai maha kua oti te tāpaki, pēnei i ngā kai kua oti te tio, ngā hupa kua oti te kānana me ngā kai tere. Ko ētahi atu kai kua tāpirihia te tote ko ngā kai kai reka tote, ngā huawhenua kua oti te kānana, me ngā mīti me ngā tīhi kua oti te tukatuka.
• Whakamāramahia te pāporo. He kohuke te pāporo e kitea ana i roto i ngā kai, pēnei i ngā wai inu pouri, te miraka, te oatmeal me ngā witi bran. Ki te nui rawa te pāporo i roto i tō toto, ka ngoikore ō wheua, ā, ka ngau tō kiri.

I te wā e pai ake ana ō whatukuhu, pea ka kore e hiahiatia e koe te kai motuhake. Engari he mea nui tonu te kai hauora.