Maʻi suka ma fatugaʻo

O faʻamaʻi fatugaʻo poʻo le faʻaleagaina o fatugaʻo e masani ona tupu i le taimi o tagata i le maʻisuka. Lenei ituaiga o faʻamaʻi fatugaʻo e taʻua o le suka suka nephropathy.

O fatugaʻo taʻitasi e faia i le selau o afe o tamaʻi iunite e taʻu o nephrons. O nei fausaga e faʻamama lou toto, fesoasoani e aveʻesea otaota mai le tino, ma faʻatonutonu paleni vai.

I tagata e maʻi suka, e lemu lava le mafiafia o nephrons ma faʻamaʻaina ai ile taimi. Ua amata ona paʻu le nephrons, ma pasia le protein (albumin) i le miaga. Lenei faʻaleagaina mafai ona tupu tausaga ae leʻi i ai ni faʻailoga o faʻamaʻi fatugaʻo.

Faʻaleagaina fatugaʻo e ono tupu pe a fai o oe:

• Ia i ai le suka le toto pulea
• Ua puta puta
• Maualuga le toto
• Maua le maʻisuka ituaiga 1 na amata ae e te leʻi 20 tausaga
• Maua tagata o le aiga o loʻo maua foʻi ile maʻi suka ma fatugaʻo
• Asu
• O Aferika Amerika, Mekisiko Amerika, poʻo Native American

Tele taimi, e leai ni faʻailoga a o amata ona leaga le fatuga ma faifai malie ai lava ona leaga. Faʻaleagaina fatugaʻo mafai ona amata 5 i le 10 tausaga ae le i amataina faʻailoga.

Tagata e sili atu ogaoga ma umi-taimi (tumau) fatugaʻo faʻamaʻi ono i ai faʻailoga pei o:

• Le lava ile tele ole taimi
• Lagona lautele maʻi
• Tigā ulu
• Paʻu fatu e le masani ai
• Faanoi ma puaʻi
• Le lelei le fiaai
• Fulafula vae
• Manava le mānava
• Paʻu paʻu
• Faigofie atiina ae siama

O lau fomaʻi tausi soifua o le a okaina suʻega e iloa ai faʻailoga o fatugaʻo faʻafitauli.

O le suʻesuʻe suʻega vaʻai mo se porotini, ua faʻaigoaina o le albumin, o loʻo paʻu atu i le miaga.

• Ole tele ole albumin ile miaga e masani ona fai ma faʻailoga ole faʻaleagaina ole fatugaʻo.
• O lenei suʻega e taʻua foi ole suʻega ole microalbuminuria aua e fua ai le laʻititi o le albumin.

O le a suʻesuʻe foi e lau tautua lou toto maualuga. Ole toto maualuga e faʻaleagaina ou fatugaʻo, ma ole toto maualuga e faigata ona taofi pe a iai sau faʻamaʻi fatu.

E mafai ona okaina se biopsy o fatugao e faʻamaonia ai le faʻamaoniga pe vaʻai mo isi mafuaʻaga o le faʻaleagaina o fatugaʻo.

Afai e maua oe ile maʻi suka, e siaki foi e lau tautua au fatugaʻo ile faʻaaogaina o suʻega ole toto nei i tausaga uma.

• O le urea nitrogen (BUN)
• Serum foafoa
• Fuafua glomerular filtration fua faatatau (GFR)

A afaina le fatugaʻo ua maua i ona amataga, e mafai ona faifai lemu ma togafitiga. O le taimi e tele ai le aofaʻi o polotini e aliali mai i le miaga, fatugaʻo faʻaleagaina o le a faifai malie ona atili leaga.

Mulimuli i le fautuaga a lau kamupani e faʻatumauina lou tulaga mai le leaga atili.

TULAFONO LOU TINO TINO

Taofiofia lou toto i lalo o le faʻatonutonuina (lalo 140/90 mm Hg) o se tasi o sili auala e faʻatelegese fatugaʻo faʻaleagaina.

• O le a faʻatonuina e lau tautua ni vailaʻau o le toto e puipui ai ou fatugaʻo mai le tele o mea faʻaletonu pe a fai o lau suʻega microalbumin e maualuga atu i le lua fuataga.
• Afai o lou toto maualuga i le tulaga masani ma oe i ai microalbuminuria, oe ono talosagaina e inu fualaʻau toto, ae o lenei fautuaga ua finau nei.

TULAFONO LOU TULAGA TAULAU Toto

Oe mafai foi faʻatelegese fatuga faʻaleagaina e ala i le faʻatonutonuina o lou toto suka tulaga ala i:

• Aai i meaai maloloina
• Faʻamalositino masani
• Aveina o fofoga poʻo vailaʻau tuiina pei o faʻatonuga e lau tautua
• O nisi vailaʻau o le maʻisuka e iloa e puipuia le alualu i luma o le suka suka nephropathy sili atu nai lo isi vailaʻau. Talanoa i lau tautua e uiga i vailaʻau e sili mo oe.
  
• O le siakiina o le maualuga o le suka i lou toto i taimi uma e pei ona faatonuina ai ma le faʻamaumauina o lau numera suka i lou toto ia e iloa ai pe faʻapefea ona aʻafia lou tulaga i meaʻai ma gaioiga.

Isi Auala e Puipuia ai au Tamaiti

• Faʻatusatusa lanu e masani ona faʻaaogaina ile MRI, CT scan, poʻo isi faʻataʻitaʻiga faʻataʻitaʻi e mafai ona mafua ai le tele o le faʻaleagaina o ou fatugaʻo. Taʻu i le kamupani o loʻo okaina le suʻega o loʻo e maʻi suka. Mulimuli i faʻatonuga e uiga ile inu tele o vai peʻa maeʻa le faʻagaioiga e lafo ese ai le vali mai lau tino.
• Aloʻese mai le inuina o se NSAID tiga vailaʻau, pei o ibuprofen po naproxen. Fesili i lau tautua pe o iai seisi ituaiga vailaʻau e mafai ona e inu ai. NSAIDs mafai ona faʻaleagaina le fatugaʻo, sili atu pe a e faʻaaogaina i aso uma.
• Atonu e manaʻomia e lau tautua le taofi pe sui isi vailaʻau e ono faʻaleagaina ai ou fatugaʻo.
• Iloa faʻailoga o faʻamaʻi pipisi ma ia vave ona togafitia.
• O le i ai o se maualalo tulaga o le vaitamini D ono faʻateleina faamaʻi fatugaʻo. Fesili i lau fomaʻi pe a manaʻomia lou inuina o fualaʻau D.

Tele fesoasoani e mafai ona fesoasoani ia oe e malamalama atili ai ile maʻi suka. Oe mafai foi aʻoaʻo auala e pulea ai lou faʻamaʻi fatugao.

O le maʻi suka o le maʻi suka o se mafuaʻaga tele o maʻi ma maliu i tagata e maua i le maʻisuka. E mafai ona taitai atu ai i le manaomia mo dialysis po o se fatugaʻi tuiina.

Valaʻau lau tautua peʻa e maua ile maʻisuka ma e leʻi faia sau suʻega i le miaga e siaki ai le polotini.

Nephropathy suka; Nefofoa - maʻi suka; Maʻi suka glomerulosclerosis; Kimmelstiel-Wilson faamaʻi

• Aisa taofi
• Ituaiga 2 suka - o le a le fesili i lau fomaʻi

• Lalolagi urinary faiga
• Pancreas ma fatugaʻo
• Nephropathy suka

American Diabetes Association. 11. Faʻafitauli Microvascular ma tausiga o vae: tulaga masani o togafitiga faʻafomaʻi ile maʻisuka-2020. Maʻi suka. 2020; 43 (Faʻaopopo 1): S135-S151. PMID: 31862754 pubmed.ncbi.nlm.nih.gov/31862754/.

Brownlee M, Aiello LP, Sun JK, et al. Faʻafitauli o le maʻisuka mellitus. I: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Tusitusiga o Endocrinology. 14th lomiga. Filatelefia, PA: Elsevier; 2020: chap 37.

Tong LL, Adler S, Wanner C. Puipuiga ma togafitiga o faʻamaʻi o le fatu suka. I le: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Faʻamatalaga auʻiliʻi 6th ed. Filatelefia, PA: Elsevier; 2019: chap 31