Oge tupu azotemia

Prerenal azotemia bu oke nkpuru ahihia nke nitrogen na emebi.

A na-ahụkarị azotemia, karịsịa na ndị okenye na ndị nọ n'ụlọ ọgwụ.

Akụrụ na-enyocha ọbara. Ha na-agba mamịrị iji wepu ihe mkpofu. Mgbe ọ̀tụ̀tụ̀, ma ọ bụ ọ̀tụ̀tụ̀, nke ọbara na-esi n’akụkụ akụrụ na-agbadata, nzacha nke ọbara na-adapụtakwa. Ma ọ bụ ọ nwere ike ọ gaghị eme ma ọlị. Ihe mkpofu na-anọgide n'ọbara. Obere ma ọ bụ enweghị mmamịrị, n'agbanyeghị na akụrụ n'onwe ya na-arụ ọrụ.

Mgbe ngwongwo nitrogen, dị ka creatinine na urea, na-eto n'ime ahụ, a na-akpọ ọnọdụ azotemia. Ihe mkpofu ndị a na-eme dị ka nsi mgbe ha na-ewuli elu. Ha na-emebi akwara ma belata ike nke akụkụ ahụ iji rụọ ọrụ.

Prerenal azotemia bu udiri akụrụ na akarị na ụlọ ọgwụ. Ọnọdụ ọ bụla nke na-ebelata ọbara na-eru akụrụ nwere ike ịkpata ya, gụnyere:

• Ọkụ
• Ọnọdụ ndị na-ekwe ka mmiri gbapụ n’ọbara
• Ogologo oge, afọ ọsịsa, ma ọ bụ ọbara ọgbụgba
• Ikpo ọkụ
• Mbelata oriri (akpịrị ịkpọ nkụ)
• Ọnwụ nke olu ọbara
• Medicinesfọdụ ọgwụ, dị ka ndị na-egbochi ACE (ọgwụ ndị na-agwọ ọrịa obi ma ọ bụ ọbara mgbali elu) na ndị NSAID

Ọnọdụ nke obi na-enweghị ike ịmịnye ọbara zuru oke ma ọ bụ wụọ ọbara na obere olu na-emekwa ka ohere nke azotemia na-amụba. Ọnọdụ ndị a gụnyere:

• Obi mgbawa
• Ujo (septic ujo)

Enwere ike ibute ya site na ọnọdụ na - egbochi ịgbanye ọbara na akụrụ, dịka:

• Typesfọdụ ịwa ahụ
• Nmerụ ahụ maka akụrụ
• Mgbochi nke akwara nke na-enye ọbara akụrụ (gbasara akwara akwara)

Prestalal azotemia nwere ike ọ nweghị ihe mgbaàmà. Ma ọ bụ, ihe mgbaàmà nke ihe kpatara pretinal azotemia nwere ike ịdị.

Mgbaàmà nke akpịrị ịkpọ nkụ nwere ike ịdị ma gụnye ihe ndị a:

• Mgbagha
• Mbelata ma ọ bụ enweghị mmepụta mamịrị
• Akọrọ ọnụ n'ihi akpịrị ịkpọ nkụ
• Ọsọ ọsọ
• Ike ọgwụgwụ
• Agba dị ọcha
• Ọzịza

Nnyocha nwere ike igosi:

• Gbajiri olu veins
• Akọrọ mucous membranes
• Little ma ọ bụ enweghị mmamịrị na eriri afo
• Ọbara mgbali elu
• Ọrụ obi ala ma ọ bụ hypovolemia
• Ọkpụkpụ na-adịghị mma nke anụ ahụ (turgor)
• Otutu obi
• Belata nsogbu usu
• Ihe ịrịba ama nke nnukwu akụrụ akụrụ

Enwere ike ịme ule ndị a:

• Ọbara creatinine
• BUN
• Mmamịrị osmolality na ike ndọda
• Mmamịrị na-elele sodium na creatinine etoju na inyocha akụrụ ọrụ

Ihe mgbaru ọsọ bụ isi nke ọgwụgwọ bụ idozi ihe kpatara ya ngwa ngwa tupu akụrụ emebi. Ọ na-adịkarị ndị mmadụ mkpa ịnọ n’ụlọ ọgwụ.

Mmiri intravenous (IV), gụnyere ọbara ma ọ bụ ngwaahịa ọbara, nwere ike iji mee ka ọbara dịkwuo elu. Mgbe emeghachiri olu obara, enwere ike iji ogwu:

• Mee ka ọbara mgbali elu
• Mee ka mgbapụta nke obi dị mma

Ọ bụrụ na onye ahụ nwere mgbaàmà nke nnukwu ọdịda akụrụ, ọgwụgwọ nwere ike ịgụnye:

• Ọrịa
• Nri na-agbanwe
• Ọgwụ

Enwere ike ịtụgharị azotemia tupu ọ bụrụ na enwere ike ịchọta ihe kpatara ya ma dozie ya n'ime awa 24. Ọ bụrụ na edozi ihe kpatara ya ngwa ngwa, mmebi nwere ike ime ka akụrụ (nnukwu tubular necrosis).

Nsogbu nwere ike ịgụnye:

• Nnukwu akụrụ akụrụ
• Nnukwu tubular necrosis (anụ ahụ ọnwụ)

Gaa na ụlọ mberede ma ọ bụ kpọọ nọmba mberede obodo (dịka 911) ma ọ bụrụ na ị nwere mgbaàmà nke itu azotemia tupu oge eruo.

Treatinggwọ ọnọdụ ọ bụla nke na-ebelata olu ma ọ bụ ike nke ọbara na-aga site na akụrụ nwere ike inye aka gbochie azotemia tupu oge eruo.

Azotemia - prerenal; Uremia; Gburugburu; Nnukwu mgbapụta akụrụ - prerenal azotemia

• Akụrụ anatomi
• Akụrụ - ọbara na mmamịrị na-asọ

Haseley L, Jefferson JA. Pathophysiology na etiology nke nnukwu mmerụ akụrụ. Na: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. Nke isii. Philadelphia, PA: Elsevier; 2019: isi 66.

Okusa MD, Portilla D. Pathophysiology nke nnukwu mmerụ akụrụ. Na: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner na Rector nke akụrụ. Nke 11. Philadelphia, PA: Elsevier; 2020: isi 28.

Wolfson AB. Gbasara akụrụ. Na: Mgbidi RM, Hockberger RS, Gausche-Hill M, eds. Ngwọta Mberede nke Rosen: Echiche na usoro ọgwụgwọ. Agba nke 9. Philadelphia, PA: Elsevier; 2018: isi 87.