hrtcmKnImbv Hcp kq ssKUv

hrIsf kwcnpIhrtcmK{]Xntcm[sbpw

NnInsbbpwpdnv kq hnhcw

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnv

tUm. kRvPbv ]mWvUy Fw.Un., Un.F._n.Ikv s\t{^mfPnv

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200 paged kidney guide in following languages

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Indian Languages

Hindi, Bengali, Gujarati, Marathi, Telugu,

Malayalam, Kutchi, Tamil, Kannada & Punjabi

hrtcmKnImbv Hcp kq ssKUv

hrIsf kwcnpIhrtcmK{]Xntcm[sbpw

NnInsbbpwpdnv kq hnhcw

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnv

tUm. kRvPbv ]mWvUy Fw.Un., Un.F._n.Ikv s\t{^mfPnv

Free!! Kidney Guide in 10+ Languages at

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Free access to read, download and print

200 paged kidney guide in following languages

International Languages

English, Spanish & Chinese

Indian Languages

Hindi, Bengali, Gujarati, Marathi, Telugu,

Malayalam, Kutchi, Tamil, Kannada & Punjabi

hrIsf kwcnpI

PublisherSamarpan Kidney Foundation,Samarpan Hospital, Near Lodhavad Police Station,Bhutkhana Chowk, Rajkot 360002( Gujarat, India)

Samarpan kidney foundation

ISBN 978-81-924049-9-8All rights are reserved. No part of this book may be reproduced in any formor by any electronic or mechanical means, including information storageand retrieval systems without written permission of publisher. This book isfor publication in India and cannot be exported without prior permission inwriting from the publisher. In case of dispute all legal matter to be settledunder Rajkot jurisdiction only.

Hmw ]Xnvhne: 150 cq

teJI

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnv.Amala Hospital, Thrissur 680555.

Cu ]pkvXIw Fm hrtcmKnIpwth-n kanncnpp

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hrIsf kwcnpI

PublisherSamarpan Kidney Foundation,Samarpan Hospital, Near Lodhavad Police Station,Bhutkhana Chowk, Rajkot 360002( Gujarat, India)

Samarpan kidney foundation

ISBN 978-81-924049-9-8All rights are reserved. No part of this book may be reproduced in any formor by any electronic or mechanical means, including information storageand retrieval systems without written permission of publisher. This book isfor publication in India and cannot be exported without prior permission inwriting from the publisher. In case of dispute all legal matter to be settledunder Rajkot jurisdiction only.

Hmw ]Xnvhne: 150 cq

teJI

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnv.Amala Hospital, Thrissur 680555.

Cu ]pkvXIw Fm hrtcmKnIpwth-n kanncnpp

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hrIsf kwcnmw

hrtcmKnIfpsS Fw {IamXoXambn hnp sIm-ncnpp.hrkvXw`\w NnInnv t`Zamm IgnbpIbn. Cu tcmKwhcmsX Asn AXns ]ptcmKXn XSbpI FXmWvhrtcmKs {]Xntcm[npXn\p BZy ]Sn. hrtcmKspdnpw AXns {]iv\sfpdnpw Hcp km[mcWmcs `mjbn Cu ]pkvXIn N sNbvXncnpp.tcmK\nbw, AXnse \qX\ hnZyI tcmKn ]ment-NnI, ` W{Iaw, NnInm coXnI, tcmKnbpsS AhbvvA\ptbmPyambh Chsbmw Cu ]pkvXIn {]Xn]mZnncnpp. tcmKn am{Xa IpSpw_nse ap AwKpwCXpaqew kmnIhpw imcocnIhpw am\nIhpw Bbti t\cntS-n hcpp. Xqew Bibpw BImwjbpwhnpp. Hcp tcmKnbpsS _p Adntb-Xmb FmImcyfpw CXn hyambn ]dbpp. hrtcmKkm[yXbphpw, {]taltcmKnIpsamw hrtcmKspdn vhyamb [mcWbp-mIm Cu ]pkvXIw {]tbmP\sSpw.

BiwkItfmsS,tUm.Pbv tXmakvtUm.kRvPbv ]mWvUy

{]oXn ]mWvUyB\n tXmakv

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hrIsf kwcnmw

hrtcmKnIfpsS Fw {IamXoXambn hnp sIm-ncnpp.hrkvXw`\w NnInnv t`Zamm IgnbpIbn. Cu tcmKwhcmsX Asn AXns ]ptcmKXn XSbpI FXmWvhrtcmKs {]Xntcm[npXn\p BZy ]Sn. hrtcmKspdnpw AXns {]iv\sfpdnpw Hcp km[mcWmcs `mjbn Cu ]pkvXIn N sNbvXncnpp.tcmK\nbw, AXnse \qX\ hnZyI tcmKn ]ment-NnI, ` W{Iaw, NnInm coXnI, tcmKnbpsS AhbvvA\ptbmPyambh Chsbmw Cu ]pkvXIn {]Xn]mZnncnpp. tcmKn am{Xa IpSpw_nse ap AwKpwCXpaqew kmnIhpw imcocnIhpw am\nIhpw Bbti t\cntS-n hcpp. Xqew Bibpw BImwjbpwhnpp. Hcp tcmKnbpsS _p Adntb-Xmb FmImcyfpw CXn hyambn ]dbpp. hrtcmKkm[yXbphpw, {]taltcmKnIpsamw hrtcmKspdn vhyamb [mcWbp-mIm Cu ]pkvXIw {]tbmP\sSpw.

BiwkItfmsS,tUm.Pbv tXmakvtUm.kRvPbv ]mWvUy

{]oXn ]mWvUyB\n tXmakv

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DSw

Hmw `mKw: hrsb Ipdnv BapJw

Aymbw 1 BapJw 01

Aymbw 2 hrbpw {]h\hpw 03Aymbw 3 hrtcmKns eW 10Aymbw 4 hrtcmK \nbw 12

Aymbw 5 {][m\ hr tcmK 18Aymbw 6 hr tcmKw anYym[mcWI 22Aymbw 7 hrtcmKs Fs\ XSbmw? 26

c-mw `mKw:{][m\ hrtcmKfpw NnInbpw

Aymbw 8 hrkvXw`\w 32Aymbw 9 XmXvImenI hrkvXw`\w 34

Aymbw 10 amcIamb hrtcmK ImcW 39Aymbw 11 amcIamb hrtcmK eWfpw

NnInbpw 41

Aymbw 12 hrtcmKhpw NnInbpw 47Aymbw 13 Ubmennkv 51Aymbw 14 hramn hbv 66

av {][m\ hrtcmK

Aymbw 15 {]talhpw hrtcmKhpw 80Aymbw 16 t]mfnknnv hrtcmKw 87Aymbw 17 H hrbpw PohnXhpw 93

Aymbw 18 aq{Xmib AWp_m[ 96Aymbw 19 hrbpw Ipw 99Aymbw 20 t{]mkvtSv {Kn 111

Aymbw 21 hrbpw acppIfpw 114Aymbw 22 s\t{^mnIv knt{Umw 116Aymbw 23 IpnIfnse aq{Xmib AWp_m[ 123

Aymbw 24 InSbnse aq{Xsamgnv 127

hrtcmKn ]ment- `W{Iaw

Aymbw 25 hrtcmKn ]ment- `W{Iaw 129

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DSw

Hmw `mKw: hrsb Ipdnv BapJw

Aymbw 1 BapJw 01

Aymbw 2 hrbpw {]h\hpw 03Aymbw 3 hrtcmKns eW 10Aymbw 4 hrtcmK \nbw 12

Aymbw 5 {][m\ hr tcmK 18Aymbw 6 hr tcmKw anYym[mcWI 22Aymbw 7 hrtcmKs Fs\ XSbmw? 26

c-mw `mKw:{][m\ hrtcmKfpw NnInbpw

Aymbw 8 hrkvXw`\w 32Aymbw 9 XmXvImenI hrkvXw`\w 34

Aymbw 10 amcIamb hrtcmK ImcW 39Aymbw 11 amcIamb hrtcmK eWfpw

NnInbpw 41

Aymbw 12 hrtcmKhpw NnInbpw 47Aymbw 13 Ubmennkv 51Aymbw 14 hramn hbv 66

av {][m\ hrtcmK

Aymbw 15 {]talhpw hrtcmKhpw 80Aymbw 16 t]mfnknnv hrtcmKw 87Aymbw 17 H hrbpw PohnXhpw 93

Aymbw 18 aq{Xmib AWp_m[ 96Aymbw 19 hrbpw Ipw 99Aymbw 20 t{]mkvtSv {Kn 111

Aymbw 21 hrbpw acppIfpw 114Aymbw 22 s\t{^mnIv knt{Umw 116Aymbw 23 IpnIfnse aq{Xmib AWp_m[ 123

Aymbw 24 InSbnse aq{Xsamgnv 127

hrtcmKn ]ment- `W{Iaw

Aymbw 25 hrtcmKn ]ment- `W{Iaw 129

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teJIscpdnv

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnvkn.Fw.kn. shqcn \npw s\t{^mfPnbn _ncpZm\c_ncpZw t\Sn. XpSvXriq Aae saUn tImtfPvBip]{Xnbn hrtcmK hn`mKw ta[mhnbmbn {]hnpp.

tUm. kRvPbv ]mWvUy Fw.Un. Un.F._n.(s\t{^mfPn)cmPvtImn {]mIvSokv sNpp tUm.kRvPbv]mWvUy AlZm_mZnse InUv\n Unkokv &dnkv skdn \nv s\t{^mfPnbnUn.F._n. _ncp[w t\Sn. 1990 apXhrtcmK hnZKvZ\mbn tkh \a\pjvTnpp.hrtcmK sfpdnv s]mXpP\ns\

t_m[hcnpI F DtitmSp IqsS InUv\nFUyptj ^ ut-j cq]hcnp. ap kwm\fnsehrtcmK hnZKv[cpambn tNp Cybnse an ` mjIfnepw HcpssKUv {]knoIcnnp-v. hrIsf kwcnpI F ssKUvFmhpw {]tbmP\IcamIp Hcp ]pkvXIamWv.

Cu ]pkvXIw Fs\ D]tbmKnmw?

Cu ]pkvXIw c-p`mKambn XcwXncnncnpp

`mKw 1.BZy`mKneqsS hrbpsS {]m[m\yspdnpw {]h\sfpdnpw hniZoIcnpp. hrtcmKnIfpw AhcpsSIpSpw_mwKfpw Adnncnt- Imcyfpw hyambn CXn{]Xn]mZnnp-v. Fmhcpw CXv hmbnWw.

`mKw 2.Cu `mKw CjvSm\pkcWw hmbnmw.

hrtcmKspdnpw AXns A\c^esfpdnpwtcmK{]Xntcm[sbpw NnInsbbpwpdnpw {]Xn]mZnpp.

ckhpw {]talhpaph tcmK\nbw t\cs\Sp hgn Fs\ tcmKs Hcp Afhphsc sNdpmwFXns\pdn v ]dncnpp.

hrtcmKn ]ment- `W{Iaw.

Cu ]pkvXIn {]Xn]mZnnp hnhcw tUmIvSdpsS\ntin\p ]IcapX;tUmIvSdpsS \nti{]ImcamsX kzbw NnIn sNpXvtZmjIcamWv.

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teJIscpdnv

tUm. Pbv tXmakv amXyp Fw.Un., Un.Fw.Ikv s\t{^mfPnvkn.Fw.kn. shqcn \npw s\t{^mfPnbn _ncpZm\c_ncpZw t\Sn. XpSvXriq Aae saUn tImtfPvBip]{Xnbn hrtcmK hn`mKw ta[mhnbmbn {]hnpp.

tUm. kRvPbv ]mWvUy Fw.Un. Un.F._n.(s\t{^mfPn)cmPvtImn {]mIvSokv sNpp tUm.kRvPbv]mWvUy AlZm_mZnse InUv\n Unkokv &dnkv skdn \nv s\t{^mfPnbnUn.F._n. _ncp[w t\Sn. 1990 apXhrtcmK hnZKvZ\mbn tkh \a\pjvTnpp.hrtcmK sfpdnv s]mXpP\ns\

t_m[hcnpI F DtitmSp IqsS InUv\nFUyptj ^ ut-j cq]hcnp. ap kwm\fnsehrtcmK hnZKv[cpambn tNp Cybnse an ` mjIfnepw HcpssKUv {]knoIcnnp-v. hrIsf kwcnpI F ssKUvFmhpw {]tbmP\IcamIp Hcp ]pkvXIamWv.

Cu ]pkvXIw Fs\ D]tbmKnmw?

Cu ]pkvXIw c-p`mKambn XcwXncnncnpp

`mKw 1.BZy`mKneqsS hrbpsS {]m[m\yspdnpw {]h\sfpdnpw hniZoIcnpp. hrtcmKnIfpw AhcpsSIpSpw_mwKfpw Adnncnt- Imcyfpw hyambn CXn{]Xn]mZnnp-v. Fmhcpw CXv hmbnWw.

`mKw 2.Cu `mKw CjvSm\pkcWw hmbnmw.

hrtcmKspdnpw AXns A\c^esfpdnpwtcmK{]Xntcm[sbpw NnInsbbpwpdnpw {]Xn]mZnpp.

ckhpw {]talhpaph tcmK\nbw t\cs\Sp hgn Fs\ tcmKs Hcp Afhphsc sNdpmwFXns\pdn v ]dncnpp.

hrtcmKn ]ment- `W{Iaw.

Cu ]pkvXIn {]Xn]mZnnp hnhcw tUmIvSdpsS\ntin\p ]IcapX;tUmIvSdpsS \nti{]ImcamsX kzbw NnIn sNpXvtZmjIcamWv.

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Aymbw 1BapJw

a\pjy icocnse AhbhamWv hr AYhm InUv\n.hr F Ahbhw amen\ys ]pdp ApX {]{Inb\nlnpp. amen\yw ]pdp ASnm\ {]{InbIqSmsX icocnse ckw, shns Afhv [mXpehWw ChbpsS Afhv CsXmw \nb{npp. c-p hra\pjyicocn Ds-nepw Hp sIm-pw Cu ]d{]{InbI icocn\v \Sphm km[npp.{]talw ckw Chbp tcmKnIfn ASpnSbmbnhrtcmKw IqSpXembn ImWsSpp. Cu ]pkvXIneqsShrtcmKspdnv s]mXpP\pw, hrtcmKw _m[nhpw Hcp t_m[hXvIcWamWv DtinpXv. hr tcmKwBsc Ftm Fs\ _m[npp. Chsbmw hniZoIcnpIhgn tcmKs t\cnSm tcmKnsb IqSpX Xmdmpp. am{Xa]e kwibfpw Cu ]pkvXIw \nhmcWw sNpp.hmb\mcs\ hrsb ]cnNbsSpn XpSp Cu]pkvXIw hrsb icocns Ahn`mPyLSIamn amp{]h\spdnv hniZoIcnpp.hrtcmKnIfpsS Fn ASpImembn {IamXoXambnh\hv I-p hcpp. ckhpw {]talhpw DtcmKnIfpsS Fhpw \psS \mn hnphcptXmsSmwhrtcmKnIfpsS Fhpw hnphcpp. Cu kmlNcynhrtcmKspdnpw AXns A\c ^esfpdnpwtcmK{]Xntcm[sbpw NnInsbpdnpw s]mXpP\v\nambpw Hcp icnbmb Aht_m[w D-mtI-Xv

hr amen\ys ]pdpApX {]{Inb \nlnpp

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Aymbw 1BapJw

a\pjy icocnse AhbhamWv hr AYhm InUv\n.hr F Ahbhw amen\ys ]pdp ApX {]{Inb\nlnpp. amen\yw ]pdp ASnm\ {]{InbIqSmsX icocnse ckw, shns Afhv [mXpehWw ChbpsS Afhv CsXmw \nb{npp. c-p hra\pjyicocn Ds-nepw Hp sIm-pw Cu ]d{]{InbI icocn\v \Sphm km[npp.{]talw ckw Chbp tcmKnIfn ASpnSbmbnhrtcmKw IqSpXembn ImWsSpp. Cu ]pkvXIneqsShrtcmKspdnv s]mXpP\pw, hrtcmKw _m[nhpw Hcp t_m[hXvIcWamWv DtinpXv. hr tcmKwBsc Ftm Fs\ _m[npp. Chsbmw hniZoIcnpIhgn tcmKs t\cnSm tcmKnsb IqSpX Xmdmpp. am{Xa]e kwibfpw Cu ]pkvXIw \nhmcWw sNpp.hmb\mcs\ hrsb ]cnNbsSpn XpSp Cu]pkvXIw hrsb icocns Ahn`mPyLSIamn amp{]h\spdnv hniZoIcnpp.hrtcmKnIfpsS Fn ASpImembn {IamXoXambnh\hv I-p hcpp. ckhpw {]talhpw DtcmKnIfpsS Fhpw \psS \mn hnphcptXmsSmwhrtcmKnIfpsS Fhpw hnphcpp. Cu kmlNcynhrtcmKspdnpw AXns A\c ^esfpdnpwtcmK{]Xntcm[sbpw NnInsbpdnpw s]mXpP\v\nambpw Hcp icnbmb Aht_m[w D-mtI-Xv

hr amen\ys ]pdpApX {]{Inb \nlnpp

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AXymhiyamWv. am{Xa s]mXphmbn Cu tcmKs kw_nvDbphcmdp kwibpw adp]Sn Cu ]pkvXIneqsS\Ipp.Cu ]pkvXIns BZy`mKneqsS hrbpsS {]m[m\yspdnpw {]h\sfbpwpdnpw hniZoIcnpp.hrtcmKnIfpw AhcpsS IpSpw_mwKfpw Adnncnt-Imcyfpw hyambn CXn {]Xn]mZnnp-v. hr tcmKw,eW, tcmK\nbw, \nehnep NnInmcoXnIChsbmw CXn DsSpnbncnpp. Nne AymbfntcmK\nbw t\cs \SpXp hgn Fs\ tcmKs HcpAfhp hsc sNdpmw FXns\pdnv ]dncnpp.hr tcmKsfpdnpw AXp kw_nv \nehnep sXmb[mcWIsfpdnpw ]dbpXp hgn P\nSbn icnbmb[mcWI D-mIphm\pw tcmKs {]Xntcm[nphm\pw Hcp{iaw Cu ]pkvXIneqsS \Snbncnpp.Cu ]pkvXIn ]cmainnp Imcy Hcp ssKUv F\nebvv D]tbmK{]ZamWv. Fm CXv hmbnv kzbwNnInbvv Bcpw apXnccpXv. tUmIvSdpsS \nti{]Imcwam{Xw NnInI sNmhp.

Aymbw 2hrbpw {]h\hpw

icocnse hfsc koamb tPmenI ssIImcyw sNpHcp AhbhamWv hr. CXns {]h\Icm KpcpXcambtcmKmhbvpw acWn\pw hsc CSbmntbmw. hrbpsSASnm\]camb c-p tPmenI.

1. amen\yw ]pdpI.2. shns Afhv, {ZmhI, cmk]Zm Ch

sbmw \nnX Afhn \nb{npI.

hrbpsS LS\aq{XneqsSbmWv hr amen\ys ]pdpXv. hr DZv mZnnp aq{Xw aq{Xhmln\nbneqsS kcnv aq{Xknbnsen aq{X\mfn hgn ]pdtbvv t]mIpp.

aq{X\mfn bqdo{Xaq{Xhmln\n bpdo

1. `qcn`mKhpw Bmcn kv{Xobnepw ]pcpj\nepw c-phrI BWv DXv.

2. DZcn\pn \sns Ccphimbn hr nXnsNpp. hmcnsbpIfpw Nppap AhbhfpwIqSntv hfsctbsd kpcnXambnmWv hrIkwcnsncnpXv.

3. hr DZcns ]n`mKp Ghpw ]ndInembXn\mepw_mlyambn AXns\ sXmSpI km[ya.

2. hrIsf kwcnpI

`qcn`mKhpw Bmcn c-p hrI BWv DXvCXv hmbnv kzbw NnInbvv Bcpw apXnccpXv

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AXymhiyamWv. am{Xa s]mXphmbn Cu tcmKs kw_nvDbphcmdp kwibpw adp]Sn Cu ]pkvXIneqsS\Ipp.Cu ]pkvXIns BZy`mKneqsS hrbpsS {]m[m\yspdnpw {]h\sfbpwpdnpw hniZoIcnpp.hrtcmKnIfpw AhcpsS IpSpw_mwKfpw Adnncnt-Imcyfpw hyambn CXn {]Xn]mZnnp-v. hr tcmKw,eW, tcmK\nbw, \nehnep NnInmcoXnIChsbmw CXn DsSpnbncnpp. Nne AymbfntcmK\nbw t\cs \SpXp hgn Fs\ tcmKs HcpAfhp hsc sNdpmw FXns\pdnv ]dncnpp.hr tcmKsfpdnpw AXp kw_nv \nehnep sXmb[mcWIsfpdnpw ]dbpXp hgn P\nSbn icnbmb[mcWI D-mIphm\pw tcmKs {]Xntcm[nphm\pw Hcp{iaw Cu ]pkvXIneqsS \Snbncnpp.Cu ]pkvXIn ]cmainnp Imcy Hcp ssKUv F\nebvv D]tbmK{]ZamWv. Fm CXv hmbnv kzbwNnInbvv Bcpw apXnccpXv. tUmIvSdpsS \nti{]Imcwam{Xw NnInI sNmhp.

Aymbw 2hrbpw {]h\hpw

icocnse hfsc koamb tPmenI ssIImcyw sNpHcp AhbhamWv hr. CXns {]h\Icm KpcpXcambtcmKmhbvpw acWn\pw hsc CSbmntbmw. hrbpsSASnm\]camb c-p tPmenI.

1. amen\yw ]pdpI.2. shns Afhv, {ZmhI, cmk]Zm Ch

sbmw \nnX Afhn \nb{npI.

hrbpsS LS\aq{XneqsSbmWv hr amen\ys ]pdpXv. hr DZv mZnnp aq{Xw aq{Xhmln\nbneqsS kcnv aq{Xknbnsen aq{X\mfn hgn ]pdtbvv t]mIpp.

aq{X\mfn bqdo{Xaq{Xhmln\n bpdo

1. `qcn`mKhpw Bmcn kv{Xobnepw ]pcpj\nepw c-phrI BWv DXv.

2. DZcn\pn \sns Ccphimbn hr nXnsNpp. hmcnsbpIfpw Nppap AhbhfpwIqSntv hfsctbsd kpcnXambnmWv hrIkwcnsncnpXv.

3. hr DZcns ]n`mKp Ghpw ]ndInembXn\mepw_mlyambn AXns\ sXmSpI km[ya.

2. hrIsf kwcnpI

`qcn`mKhpw Bmcn c-p hrI BWv DXvCXv hmbnv kzbw NnInbvv Bcpw apXnccpXv

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4. hr Hcp ]bdpaWnbpsS BIrXnbnemWv. apXnhcnhrbvv 10.skao. \ofhpw 6 sk.ao. hoXnbpw 4 sk.ao.J\hpw D-v. Hmtcm hrpw 120170 {Kmw `mcap-v.

5. hrbn \nv aq{Xw, aq{Xhmln\n (bqdn) F amwk\mfnhgn aq{Xknbn Fpp.

6. aq{Xkn Fm CSpsn\pn nXn sNp aq{XwsImp amwkwsIm-p knbmWv.

7. apXnhcpsS aq{Xknbvv 400 500 ann hsc aq{XwDsmphm\p Ignhp-v.

8. kv{XoIfn aq{X\mfn ]pcpjmtcm sNdpXmWv.9. aq{Xw aq{Xknbn \nv aq{X\mfn hgn ]pdtbvv

HgpIpp. ]pcpj\nepw kv{Xobnepw hr nXnsNpXvHtc `mKmWv.

hr icocn Fn\v?1. \ Znhkhpw ]eXcw Blmcw Ignpp.2. shns Afhv, Dns Afhv, cmk]ZmfpsS

Afhv Chbnsemw A\pZn\w hyXymkw D-mIpp.3. icocw ` Ws Duamn amptm ]eXcw hnjmwiw

DmZnnsSpp.4. Cu hnjmwi icocnse {ZmhIw, Aw, cmk ]Zm

ChbpsS Afhn hyXnbm\w hcppp. hnjmwiwBhiyne[nIw icocn \ne\nptm Pohns\ne\nns\ _m[npp.

5. aen\ ]Zm icocn \nv ]pdtv XpXnhrIv kp{][m\amb ]p-v. am{Xa icocnsBcnI ]cnXmhsb {IaoIcnpIbpw kpenXmh\ne\nm klmbnpIbpw sNpp.

hrbpsS {]h\ Fsmw?1. cipoIocWw.2. [mXpehWw, Pew, Ch \nb{n.3. ckw \nb{npI, cmWpfpsS Dev]mZ\w

\nlnpI. hrbpsS {][m\ tPmen amen\yw ]pdpXpw AXp hgn

cipoIcWw \SpIbpw BWv. icocn Bhiyanm amen\yw, Dv, cmk]Zm Chsbmw hr\ncmIcnpp.

amen\yw ]pdpI. cipoIcWw icocn kw`hnpXv hr amen\yw

]pdptmgmWv.

hrbpsS LS\

bpdo

aq{Xkn

bqdo{X

hr

4. hrIsf kwcnpI hrbpw {]h\hpw 5.

hrI icocns kpenXmh\ne\nm klmbnpw

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4. hr Hcp ]bdpaWnbpsS BIrXnbnemWv. apXnhcnhrbvv 10.skao. \ofhpw 6 sk.ao. hoXnbpw 4 sk.ao.J\hpw D-v. Hmtcm hrpw 120170 {Kmw `mcap-v.

5. hrbn \nv aq{Xw, aq{Xhmln\n (bqdn) F amwk\mfnhgn aq{Xknbn Fpp.

6. aq{Xkn Fm CSpsn\pn nXn sNp aq{XwsImp amwkwsIm-p knbmWv.

7. apXnhcpsS aq{Xknbvv 400 500 ann hsc aq{XwDsmphm\p Ignhp-v.

8. kv{XoIfn aq{X\mfn ]pcpjmtcm sNdpXmWv.9. aq{Xw aq{Xknbn \nv aq{X\mfn hgn ]pdtbvv

HgpIpp. ]pcpj\nepw kv{Xobnepw hr nXnsNpXvHtc `mKmWv.

hr icocn Fn\v?1. \ Znhkhpw ]eXcw Blmcw Ignpp.2. shns Afhv, Dns Afhv, cmk]ZmfpsS

Afhv Chbnsemw A\pZn\w hyXymkw D-mIpp.3. icocw ` Ws Duamn amptm ]eXcw hnjmwiw

DmZnnsSpp.4. Cu hnjmwi icocnse {ZmhIw, Aw, cmk ]Zm

ChbpsS Afhn hyXnbm\w hcppp. hnjmwiwBhiyne[nIw icocn \ne\nptm Pohns\ne\nns\ _m[npp.

5. aen\ ]Zm icocn \nv ]pdtv XpXnhrIv kp{][m\amb ]p-v. am{Xa icocnsBcnI ]cnXmhsb {IaoIcnpIbpw kpenXmh\ne\nm klmbnpIbpw sNpp.

hrbpsS {]h\ Fsmw?1. cipoIocWw.2. [mXpehWw, Pew, Ch \nb{n.3. ckw \nb{npI, cmWpfpsS Dev]mZ\w

\nlnpI. hrbpsS {][m\ tPmen amen\yw ]pdpXpw AXp hgn

cipoIcWw \SpIbpw BWv. icocn Bhiyanm amen\yw, Dv, cmk]Zm Chsbmw hr\ncmIcnpp.

amen\yw ]pdpI. cipoIcWw icocn kw`hnpXv hr amen\yw

]pdptmgmWv.

hrbpsS LS\

bpdo

aq{Xkn

bqdo{X

hr

4. hrIsf kwcnpI hrbpw {]h\hpw 5.

hrI icocns kpenXmh\ne\nm klmbnpw

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`Wn t{]mo ASnbncnpp. t{]mo icocnshfbvv th- Ghpw AhiyLSIamWv. ]s t{]moicocw D]tbmKnptm amen\yfpw IqsS Dev]mZnnsSpp. amen\y icocn hnjmwiambn amdpw. Cuamen\y\nm\amWv hr `wKnbmbn \nlnpXv.1. {Inbmn\n, bqdnb Cu amen\y ]ZmfpsS a\pjy

icocnse Afhv IrXyambn Afm Ignbpw. cnseCu Afhv hrbpsS {]h\ aXsbpdnpp. c-phrbpw {]h\clnXamIptm bqdnbbpw {Inbmn\n\pw cn {Iane[nIamIpp.

2. icocn A[nIap Pemwis ]pdn PensAfhv \nb{npXv hrbmWv. hr {]h\clnXamIptm icocn Pew Xn \npIbpw aq{Xwt]mImsX icocw \ocv hbvpIbpw sNpp.

3. [mXpehW, cmk]Zm, Chsb kpenXambn\npXpw, tkmUnbw, s]mmkyw, ssl{UP, Imknbw,t^mkv^dkv, aojyw Ch icocn \nnX Afhn\ne\npXpw hrbmWv. tkmUnbw IqSnbmtemIpdmtem `mKnIambn kpt_m[w \jvSsSpp.s]mmknbns GIpdn D-mbm lrZbanSnnt\bpwt]inIfpsS {]h\tbpw _m[npw. ]pw Fpw_esSpp {][m\ LSIw Imkyhpw t^mkv^dkpamWv.

4. hr Dev]mZnnp tlmtamWpIfmb sd\n, BPntbmsSkn, AtUmkvntdm, t{]mkvmmUn Pehpw Dpwicocn \nnX Afhn \ne\nn ckw

\nb{npp. Cu tlmtam Dev]mZ\n XIcmdpID-mbm Dpw shhpw icocn XpIbpw ckw A[nIamIm CSbmIpIbpw sNpw.

5. hr Dev]mZnnp Fdnt{Xmt]mbnns {][m\ tPmenNph cmWpsf Dev]mZnnpI FXmWv. Fdnt{Xmt]mbnn hr Dev]mZnnpXp IpdbpItbm CmXmhpItbm sNbvXm lotamtm_n Ipdbpw. CXv cpdhvAYhm hnf F Ah krjvSnpp.

6. hr kvXw`\w kw`hn tcmKnIfn Fdnt{Xmt]mbnnsDev]mZ\w Xqew IpdbpIbpw Ahv Atb (Ccpv)hnman acppI \IpIbpw sNt-n hcpp.

7. hnman Un.sb icocn\v Bhiyap cq]n amnsbSpp tPmen hrbpsSbmWv. Imknbw icocw hensSppXn hnman Un. {][m\ ]v hlnpp. hrtcmKnIfn hnman Un. Dev]mZ\w hrIcm aqewIpdbpIbpw ]n\pw Fn\pw _ebw D-mhpIbpwsNpp.

cw Fs\ ipoIcnsSpp. aq {Xw Fs\Dev]mZnnsSpp?

cw ipoIcWw \Sptm hr Bhiyap ]ZmhensSpv Bhiyanm Pew, ehW, amen\y Chsb]pdpp.1. lrZbn \np cns Ccp]Xp iXam\w (20%)

GItZiw 1250 ann. (HtIm en) Hmtcm hrbn IqSnHmtcm an\npw ISpt]mIpp. Atm Hcp Znhkw 100 encipoIcWw icocn \Spp.

6. hrIsf kwcnpI hrbpw {]h\hpw 7.

icocn Pens Afhv \nb{npXv hrbmWv Fdnt{Xmt]mbnns {][m\ tPmen NphcmWpsf Dev]mZnnpIbmWv

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`Wn t{]mo ASnbncnpp. t{]mo icocnshfbvv th- Ghpw AhiyLSIamWv. ]s t{]moicocw D]tbmKnptm amen\yfpw IqsS Dev]mZnnsSpp. amen\y icocn hnjmwiambn amdpw. Cuamen\y\nm\amWv hr `wKnbmbn \nlnpXv.1. {Inbmn\n, bqdnb Cu amen\y ]ZmfpsS a\pjy

icocnse Afhv IrXyambn Afm Ignbpw. cnseCu Afhv hrbpsS {]h\ aXsbpdnpp. c-phrbpw {]h\clnXamIptm bqdnbbpw {Inbmn\n\pw cn {Iane[nIamIpp.

2. icocn A[nIap Pemwis ]pdn PensAfhv \nb{npXv hrbmWv. hr {]h\clnXamIptm icocn Pew Xn \npIbpw aq{Xwt]mImsX icocw \ocv hbvpIbpw sNpp.

3. [mXpehW, cmk]Zm, Chsb kpenXambn\npXpw, tkmUnbw, s]mmkyw, ssl{UP, Imknbw,t^mkv^dkv, aojyw Ch icocn \nnX Afhn\ne\npXpw hrbmWv. tkmUnbw IqSnbmtemIpdmtem `mKnIambn kpt_m[w \jvSsSpp.s]mmknbns GIpdn D-mbm lrZbanSnnt\bpwt]inIfpsS {]h\tbpw _m[npw. ]pw Fpw_esSpp {][m\ LSIw Imkyhpw t^mkv^dkpamWv.

4. hr Dev]mZnnp tlmtamWpIfmb sd\n, BPntbmsSkn, AtUmkvntdm, t{]mkvmmUn Pehpw Dpwicocn \nnX Afhn \ne\nn ckw

\nb{npp. Cu tlmtam Dev]mZ\n XIcmdpID-mbm Dpw shhpw icocn XpIbpw ckw A[nIamIm CSbmIpIbpw sNpw.

5. hr Dev]mZnnp Fdnt{Xmt]mbnns {][m\ tPmenNph cmWpsf Dev]mZnnpI FXmWv. Fdnt{Xmt]mbnn hr Dev]mZnnpXp IpdbpItbm CmXmhpItbm sNbvXm lotamtm_n Ipdbpw. CXv cpdhvAYhm hnf F Ah krjvSnpp.

6. hr kvXw`\w kw`hn tcmKnIfn Fdnt{Xmt]mbnnsDev]mZ\w Xqew IpdbpIbpw Ahv Atb (Ccpv)hnman acppI \IpIbpw sNt-n hcpp.

7. hnman Un.sb icocn\v Bhiyap cq]n amnsbSpp tPmen hrbpsSbmWv. Imknbw icocw hensSppXn hnman Un. {][m\ ]v hlnpp. hrtcmKnIfn hnman Un. Dev]mZ\w hrIcm aqewIpdbpIbpw ]n\pw Fn\pw _ebw D-mhpIbpwsNpp.

cw Fs\ ipoIcnsSpp. aq {Xw Fs\Dev]mZnnsSpp?

cw ipoIcWw \Sptm hr Bhiyap ]ZmhensSpv Bhiyanm Pew, ehW, amen\y Chsb]pdpp.1. lrZbn \np cns Ccp]Xp iXam\w (20%)

GItZiw 1250 ann. (HtIm en) Hmtcm hrbn IqSnHmtcm an\npw ISpt]mIpp. Atm Hcp Znhkw 100 encipoIcWw icocn \Spp.

6. hrIsf kwcnpI hrbpw {]h\hpw 7.

icocn Pens Afhv \nb{npXv hrbmWv Fdnt{Xmt]mbnns {][m\ tPmen NphcmWpsf Dev]mZnnpIbmWv

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2. amen\y cnepw hrbnepw Fptm AXpipoIcnp AcnbmWv s\^vtdm (Nephron).

3. Hmtcm hrbnepw ]veIvjw s\^tdmWpIfp-v. Hmtcms\^tdmWpw tmadpekmepw Syq_pIfmepw \nnXamWv.

4. tmadpekv Fm hfsc sNdnb InIfp HcpAcnbmWv. sNdnb ]Zmfpw shhpw CXneqsSAcnsSpp. Fm Ipdv IqSn hepXmb NphcmWp, RBC,WBC, Platelets, t{]mo Ch CXneqsSAcnsSpn. AXn\m ]q BtcmKyhm\mb HcmfpsSaq{X]cntim[\bn Cu Awi ImWpIbn.

5. aq{Xw Dev]mZ\ns BZy]Sn tmadpekn \nv XpSpp. 1 an\nn 125 ann Pew AcnsSpp. 24 aWnqdn CXv 180 en Peambn amdpp. CXn amen\ywam{Xa qtmkpw ap KpWap ]ZmfpwASnbncnpp.

6. hrbn Fp 180 en Pen Syq_pIfn 99%XncnsI hensSpsSpIbpw 1% am{Xw aq{Xambn ]pdtbvp t]mIpIbpw sNpp.

7. Npcpn 178 en shhpw icocn XncnsISyq_yqfneqsS BKncWw sNsSpp. 12 en shwamen\yw, ehW, hnj]Zm Fnhbpambn]pdsSpp.

8. As\ hrbn Dev]mZnnsSp aq{Xw aq{Xhmln\nhgn aq{Xknbn Fn aq{X\mfn hgn ]pdsSpp.

BtcmKyhm\mb Hcmfn aq{Xns Afhn F{XtmfwhyXymkw hcmw?1. AItbvv FSpp shw, Aconse Xm]\ne

Ch aq{Xns Afhv \nnbnp {][m\ LSIamWv.2. shw AItbvv sNpXv Ipdbptm aq{Xw

IqSpX hocyapXpw Afhv 500 ann. hsc IpdbpIbpwsNmw. IqSpX shw Dntebvv sNm IqSpXaq{Xw Dev]mZnnsSpp.

3. DjvWIme v hnbptm aq{Xns Afhv Ipdbmw.AtX kabw XWppImev hnbpXv IpdbptmIqSpX aq{Xw D-mIpp.

4. km[mcW Afhn shw IpSnp HcmfpsS aq{Xw 3000annbn IqSpXtem 500 annbn Ipdthm hm AbmfpsS hrbvv Xobmbpw ]cntim[\ BhiyamWv.

8. hrIsf kwcnpI hrbpw {]h\hpw 9.

hrbn amen\y ipoIcnpAcnbmWv s\^vtdm

DjvWImev hnbptmaq{Xns Afhv Ipdbmw

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2. amen\y cnepw hrbnepw Fptm AXpipoIcnp AcnbmWv s\^vtdm (Nephron).

3. Hmtcm hrbnepw ]veIvjw s\^tdmWpIfp-v. Hmtcms\^tdmWpw tmadpekmepw Syq_pIfmepw \nnXamWv.

4. tmadpekv Fm hfsc sNdnb InIfp HcpAcnbmWv. sNdnb ]Zmfpw shhpw CXneqsSAcnsSpp. Fm Ipdv IqSn hepXmb NphcmWp, RBC,WBC, Platelets, t{]mo Ch CXneqsSAcnsSpn. AXn\m ]q BtcmKyhm\mb HcmfpsSaq{X]cntim[\bn Cu Awi ImWpIbn.

5. aq{Xw Dev]mZ\ns BZy]Sn tmadpekn \nv XpSpp. 1 an\nn 125 ann Pew AcnsSpp. 24 aWnqdn CXv 180 en Peambn amdpp. CXn amen\ywam{Xa qtmkpw ap KpWap ]ZmfpwASnbncnpp.

6. hrbn Fp 180 en Pen Syq_pIfn 99%XncnsI hensSpsSpIbpw 1% am{Xw aq{Xambn ]pdtbvp t]mIpIbpw sNpp.

7. Npcpn 178 en shhpw icocn XncnsISyq_yqfneqsS BKncWw sNsSpp. 12 en shwamen\yw, ehW, hnj]Zm Fnhbpambn]pdsSpp.

8. As\ hrbn Dev]mZnnsSp aq{Xw aq{Xhmln\nhgn aq{Xknbn Fn aq{X\mfn hgn ]pdsSpp.

BtcmKyhm\mb Hcmfn aq{Xns Afhn F{XtmfwhyXymkw hcmw?1. AItbvv FSpp shw, Aconse Xm]\ne

Ch aq{Xns Afhv \nnbnp {][m\ LSIamWv.2. shw AItbvv sNpXv Ipdbptm aq{Xw

IqSpX hocyapXpw Afhv 500 ann. hsc IpdbpIbpwsNmw. IqSpX shw Dntebvv sNm IqSpXaq{Xw Dev]mZnnsSpp.

3. DjvWIme v hnbptm aq{Xns Afhv Ipdbmw.AtX kabw XWppImev hnbpXv IpdbptmIqSpX aq{Xw D-mIpp.

4. km[mcW Afhn shw IpSnp HcmfpsS aq{Xw 3000annbn IqSpXtem 500 annbn Ipdthm hm AbmfpsS hrbvv Xobmbpw ]cntim[\ BhiyamWv.

8. hrIsf kwcnpI hrbpw {]h\hpw 9.

hrbn amen\y ipoIcnpAcnbmWv s\^vtdm

DjvWImev hnbptmaq{Xns Afhv Ipdbmw

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Aymbw 3hrtcmKns eW]etmgpw hrtcmKns eW ap AhbhfnemWv{]ISamhpXv. AXn\m AXns\pdnv XnI Aht_m[aps-n am{Xsa Imseqn I-p]nSnv NnInnmkm[npIbpp.km[mcW I-phcmdp eW:icocnse \ocv1. apJpw, ImepIfnepw, hbdnepw ImWp \ocmWv hr

tcmKns Ghpw km[mcWamb eWw. cmhnse DWcptm IpIv Nppw \ocv A\p`hsSpp.hrtcmKns {][m\eWamWv \ocv. Fnepw hrtcmKamWv Fm \ocpw Fan. Nne hrtcmKfnhr {]h\ XIcm kw`hnpn. Fnepw \ocv{]XysSmdp-v (DZm: s\{^mnIv knt{Umw). am{Xa FmhrtcmKpw \ocv {]XysSWsan.

2. hninmbva eW Hcp hrtcmKnbvv D-mImdp-v.amen\y Dn \npw ]pdsSm Ahbnicocnse hnjmwiw hnpp. CXpaqeamWv. tad eW {]ISamIpXv.

3. AanX ckw: hrtcmKnIfn Db ckwkm[mcWamWv. Fm 30 hbn Xmsgbp HcmfnDb ckap-mbm hrtcmKns HcpeWamImw.

4. hnf / Xf / oWw / InXv, XpSnb eWcnse lotamtm_ns Afhv IpdbptmgmWv ImWpI.

5. hnfbvv acppItfmSv icocw {]XnIcnpnsnhrtcmKw kwibnt-Xp-v.

6. IrXyambn ]dbm\mhm eW:\sns ASn`mK v thZ\, sNmdnn, icocthZ\, Imenepw,ssInepw IpSn AYhm ]nSpw, CsXmw s]mXphmbn]dbsSp _pnappIfmWv. hrtcmKw _m[nIpnIv hfpdhv, s]mpdhv, Imsev hfbpI ChI-phcpp.

7. aq{Xmib kw_amb eW. aq{Xns Afhv IpdbpI, XpSscXpSsc aq{Xw t]mIpI,

aq{Xn ctam ]gptm D-mhpI CsXmw hrtcmKns eWamWv.

aq{XNpSnn aq{X\mfnbnse AWp_m[bpsS eWamWv. aq{Xw t]mIm XSw Asn XpnXpnbmbn aq{Xw

t]mIpI. Xosc t]mImXncnpI Chbpw hrtcmKnseWfmImw.

tad Fm eWfpw hrtcmKn\v am{XambpX.AXn\m Cu eWfn GsXnepw Ds-n tUmIvSsdI-p ]cntim[nv th- sSpI \Sn hrtcmKw C FvDdp hcpWw. Hcp eWhpanmsX hrtcmKw Is-phcmw. t\cs Is-nbm hrtcmKw aqnpXv XSbmw.

hrtcmKns eW 11.

hrtcmKns eW ap AhbhfnemWv]etmgpw {]ISamhpXv

hnfbvv acppItfmSv icocw {]XnIcnpnsnhrtcmKw kwibnt-Xp-v

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Aymbw 3hrtcmKns eW]etmgpw hrtcmKns eW ap AhbhfnemWv{]ISamhpXv. AXn\m AXns\pdnv XnI Aht_m[aps-n am{Xsa Imseqn I-p]nSnv NnInnmkm[npIbpp.km[mcW I-phcmdp eW:icocnse \ocv1. apJpw, ImepIfnepw, hbdnepw ImWp \ocmWv hr

tcmKns Ghpw km[mcWamb eWw. cmhnse DWcptm IpIv Nppw \ocv A\p`hsSpp.hrtcmKns {][m\eWamWv \ocv. Fnepw hrtcmKamWv Fm \ocpw Fan. Nne hrtcmKfnhr {]h\ XIcm kw`hnpn. Fnepw \ocv{]XysSmdp-v (DZm: s\{^mnIv knt{Umw). am{Xa FmhrtcmKpw \ocv {]XysSWsan.

2. hninmbva eW Hcp hrtcmKnbvv D-mImdp-v.amen\y Dn \npw ]pdsSm Ahbnicocnse hnjmwiw hnpp. CXpaqeamWv. tad eW {]ISamIpXv.

3. AanX ckw: hrtcmKnIfn Db ckwkm[mcWamWv. Fm 30 hbn Xmsgbp HcmfnDb ckap-mbm hrtcmKns HcpeWamImw.

4. hnf / Xf / oWw / InXv, XpSnb eWcnse lotamtm_ns Afhv IpdbptmgmWv ImWpI.

5. hnfbvv acppItfmSv icocw {]XnIcnpnsnhrtcmKw kwibnt-Xp-v.

6. IrXyambn ]dbm\mhm eW:\sns ASn`mK v thZ\, sNmdnn, icocthZ\, Imenepw,ssInepw IpSn AYhm ]nSpw, CsXmw s]mXphmbn]dbsSp _pnappIfmWv. hrtcmKw _m[nIpnIv hfpdhv, s]mpdhv, Imsev hfbpI ChI-phcpp.

7. aq{Xmib kw_amb eW. aq{Xns Afhv IpdbpI, XpSscXpSsc aq{Xw t]mIpI,

aq{Xn ctam ]gptm D-mhpI CsXmw hrtcmKns eWamWv.

aq{XNpSnn aq{X\mfnbnse AWp_m[bpsS eWamWv. aq{Xw t]mIm XSw Asn XpnXpnbmbn aq{Xw

t]mIpI. Xosc t]mImXncnpI Chbpw hrtcmKnseWfmImw.

tad Fm eWfpw hrtcmKn\v am{XambpX.AXn\m Cu eWfn GsXnepw Ds-n tUmIvSsdI-p ]cntim[nv th- sSpI \Sn hrtcmKw C FvDdp hcpWw. Hcp eWhpanmsX hrtcmKw Is-phcmw. t\cs Is-nbm hrtcmKw aqnpXv XSbmw.

hrtcmKns eW 11.

hrtcmKns eW ap AhbhfnemWv]etmgpw {]ISamhpXv

hnfbvv acppItfmSv icocw {]XnIcnpnsnhrtcmKw kwibnt-Xp-v

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Aymbw 4hrtcmK \nbwhrtcmK \nbw

""X kabv apv sIm-v FSpnsn XqmsIm-v FSpt-n hcpw''. hrsb kw_n v Cu ]gsmv A\zamWv.

CKD AYhm t{ImWnv InUv\n tcmKw; mbnbmb hrtcmKw;CXv NnInnv amm km[nn. Cu Ahbn Fp HcptcmKnbpsS NnInm Nnehv hfsc ` oaambncnpw. Hcp eWhpwImWnmsX hrtcmKw \n ]Xnbncnmw. Cu XncndnhvD-mtI-Xv AXymhiyamWv.

IrXyambn tcmK ]cntim[\ \Sn tcmKw hrkvXw`\w hscFpXv \apv XSbm km[npw. am\knIhpw kmnIhpamb Hcp ]ncnapdpw HgnhmIpIbpw sNpw.

BscmsbmWv hr ]cntim[\bvv hnt[bcmtI-h?hrtcmK km[yX A[nIhpw BmWv?

CXns Dcw Bpw hrtcmKw D-mImw FXmWv.Fm IqSpX {int-Xv BcmsWv {inpI.1. hrtcmKns eW D hyn.2. {]taltcmKn.3. ckw \nb{W hnt[bamIm hyn.4. ]mccyambn {]talw, hrtcmKw, ckw Dh.5. ]pIhen, aZy]m\w, AanXhw, 60 hbn\p apIfneph.

6. thZ\kwlmcnIfpsS XpSscbp Asn ZoLImeD]tbmKaph.

7. aq{X\mfnbpsS P\m D sshIeyw.8. ta]d hn`mKn hcph Xobmbpw tUmIvSsd

IrXyambn I-v sSpI \Sn tcmK\nbw\St-XmWv.

hrtcmK \nb sSpI Gh?1. bqdn sSv : hfsc NnehpIpdXpw Ghpw ^e{]Zamb

HpamWv CXv.2. aq{X ]cntim[\bnse A]mIXI hrtcmKntebvp

hnc Nq-ntbmw.3. aq{Xn t{]mo\ns kmnyw an hr tcmKfnepw

I-phcpp. Hcp {]tal tcmKnbn t{]mo\ns kmnywaq{Xneps-n AXv hrsb _m[nnp-v FXnseWamImw.

4. aq{Xn ]gpv Ds-n aq{Xmibn AWp_m[ D-vFXns eWamWv.

5. t{]mo, Nph cmWp, Ch aq{Xn Ds-n hrhow F AkpJns eWamImw.

ssat{ImB_pan\qdnbt{]mo hfsc sNdnb Afhn aq{Xn D-mIptm AXv{]talw hrsb _m[np FXns hnfnp sNmemWv. CuAhbn icnbmb NnIn FSpm AXv hrsb ]qnXnbntep sIm-phcm km[npw. CXv {]tXyIw{int- ImcyamWv.

hrtcmK \nbw 13.

IrXyambn tcmK]cntim[\ \Snbm tcmKwhrkvXw`\w hsc FpXv \apv XSbm km[npw

aq{X ]cntim[\bnse A]mIXIhrtcmKntebvp hnc Nq-ntbmw

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Aymbw 4hrtcmK \nbwhrtcmK \nbw

""X kabv apv sIm-v FSpnsn XqmsIm-v FSpt-n hcpw''. hrsb kw_n v Cu ]gsmv A\zamWv.

CKD AYhm t{ImWnv InUv\n tcmKw; mbnbmb hrtcmKw;CXv NnInnv amm km[nn. Cu Ahbn Fp HcptcmKnbpsS NnInm Nnehv hfsc ` oaambncnpw. Hcp eWhpwImWnmsX hrtcmKw \n ]Xnbncnmw. Cu XncndnhvD-mtI-Xv AXymhiyamWv.

IrXyambn tcmK ]cntim[\ \Sn tcmKw hrkvXw`\w hscFpXv \apv XSbm km[npw. am\knIhpw kmnIhpamb Hcp ]ncnapdpw HgnhmIpIbpw sNpw.

BscmsbmWv hr ]cntim[\bvv hnt[bcmtI-h?hrtcmK km[yX A[nIhpw BmWv?

CXns Dcw Bpw hrtcmKw D-mImw FXmWv.Fm IqSpX {int-Xv BcmsWv {inpI.1. hrtcmKns eW D hyn.2. {]taltcmKn.3. ckw \nb{W hnt[bamIm hyn.4. ]mccyambn {]talw, hrtcmKw, ckw Dh.5. ]pIhen, aZy]m\w, AanXhw, 60 hbn\p apIfneph.

6. thZ\kwlmcnIfpsS XpSscbp Asn ZoLImeD]tbmKaph.

7. aq{X\mfnbpsS P\m D sshIeyw.8. ta]d hn`mKn hcph Xobmbpw tUmIvSsd

IrXyambn I-v sSpI \Sn tcmK\nbw\St-XmWv.

hrtcmK \nb sSpI Gh?1. bqdn sSv : hfsc NnehpIpdXpw Ghpw ^e{]Zamb

HpamWv CXv.2. aq{X ]cntim[\bnse A]mIXI hrtcmKntebvp

hnc Nq-ntbmw.3. aq{Xn t{]mo\ns kmnyw an hr tcmKfnepw

I-phcpp. Hcp {]tal tcmKnbn t{]mo\ns kmnywaq{Xneps-n AXv hrsb _m[nnp-v FXnseWamImw.

4. aq{Xn ]gpv Ds-n aq{Xmibn AWp_m[ D-vFXns eWamWv.

5. t{]mo, Nph cmWp, Ch aq{Xn Ds-n hrhow F AkpJns eWamImw.

ssat{ImB_pan\qdnbt{]mo hfsc sNdnb Afhn aq{Xn D-mIptm AXv{]talw hrsb _m[np FXns hnfnp sNmemWv. CuAhbn icnbmb NnIn FSpm AXv hrsb ]qnXnbntep sIm-phcm km[npw. CXv {]tXyIw{int- ImcyamWv.

hrtcmK \nbw 13.

IrXyambn tcmK]cntim[\ \Snbm tcmKwhrkvXw`\w hsc FpXv \apv XSbm km[npw

aq{X ]cntim[\bnse A]mIXIhrtcmKntebvp hnc Nq-ntbmw

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1 . ap aq{X ]cntim[\I B_pan\qdnb: 24 aWnqdn aq{Xn IqSn t]mIp

t{]mo\ns Afhv \nbnm\mWv Cu sSv sNpXv. bqdn I & skknnhnn sSv:

48 apX 72 aWnq hsc Cu sSn\v kabw th-n htbvpw. aq{X\mfnbn GXp Xcw AWp_m[bmWv FpXnsSpm th-nbmWv Cu sSv. Bn_tbmnpI\IpXpw Cu sSv ASnm\sSpnbmWv.

bqdn sSv t^m BknUv ^mv _mknen (AFB). aq{X\mfnbn D-mIp Syq_tmknkv (TB) \nbnm DsSmWnXv.

2 c]cntim[\ (Blood Tests) bqdnbbpw {Inbmn\n\pw -hr ]pdp c-p aen\ ]ZmfmWv. cnChbpsS Afhv IqSnbm hr ]qambpw {]h\awA FXns kqN\bmWv.

{Inbmn 0.9-1.2 ann.{Kmw, bqdnb 20-40 ann.{Kmw BWv t\ma.CXn Ihnm A]mIX Ds-Xns kqN\bmWv.

lntamtm_nNph cmWpsf Dev]mZnnpXn hr {][m\ ]vhlnpp. lotamtm_o Ipdbptm hnf A\p`hsSpw.Fm hnf DXpsIm-v am{Xw hrtcmKw D-v FvAan.

ap sSpItkmUnbw, s]mmknbw, t^mkv^dv, t{]mo, sImfkvt{Sm,Imkyw, ]kmc, CsXmw Bhiym\pkcWw ]cntim[nWw.3. tdUntbmfPn sSv A{Smku-v kvIm: hrbpsS henw, GsXnepw apg,

Iv, knv ChbpsS kmnyw Is-m km[npw.am{Xa aq{XXSw, aq{X\mfnbntem aq{Xpgentemaq{Xknbntem Ds-n AXpw Is-pp.hr tcmKnIfn {]tXyInpw ]qambpw {]h\clnXcpsS hrI kvIm\n sNdpXmbn ImWsSpp.

FIvktdIpI Is-m km[npw.Voiding Cystourethrogram.

Intra venous urography (IVU).

aq{Xmibw, \mfn, kn ChbpsS LS\m]camb {]iv\,aq{XXSw, IpI Chsbmw Cu sSneqsS Adnbmkm[n pp.

ap tdUntbmfPn sSpIkn.Sn kvIm, BPntbm{Km^n, Bnt{KUv/dnt{Smt{KbvUvss]tem{Km^n.

4. ap sSpI1. _tbm]vkn.2. knkvtmkvtIm]n.3. bqtdmssU\manIvkv.

14. hrIsf kwcnpI hrtcmK \nbw 15.

bqdnbbpw {Inbmn\n\pw - hr ]pdpc-p aen\ ]ZmfmWv

hr ]qambpw {]h\clnXabmkvIm\n sNdpXmbn ImWsSpp

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1 . ap aq{X ]cntim[\I B_pan\qdnb: 24 aWnqdn aq{Xn IqSn t]mIp

t{]mo\ns Afhv \nbnm\mWv Cu sSv sNpXv. bqdn I & skknnhnn sSv:

48 apX 72 aWnq hsc Cu sSn\v kabw th-n htbvpw. aq{X\mfnbn GXp Xcw AWp_m[bmWv FpXnsSpm th-nbmWv Cu sSv. Bn_tbmnpI\IpXpw Cu sSv ASnm\sSpnbmWv.

bqdn sSv t^m BknUv ^mv _mknen (AFB). aq{X\mfnbn D-mIp Syq_tmknkv (TB) \nbnm DsSmWnXv.

2 c]cntim[\ (Blood Tests) bqdnbbpw {Inbmn\n\pw -hr ]pdp c-p aen\ ]ZmfmWv. cnChbpsS Afhv IqSnbm hr ]qambpw {]h\awA FXns kqN\bmWv.

{Inbmn 0.9-1.2 ann.{Kmw, bqdnb 20-40 ann.{Kmw BWv t\ma.CXn Ihnm A]mIX Ds-Xns kqN\bmWv.

lntamtm_nNph cmWpsf Dev]mZnnpXn hr {][m\ ]vhlnpp. lotamtm_o Ipdbptm hnf A\p`hsSpw.Fm hnf DXpsIm-v am{Xw hrtcmKw D-v FvAan.

ap sSpItkmUnbw, s]mmknbw, t^mkv^dv, t{]mo, sImfkvt{Sm,Imkyw, ]kmc, CsXmw Bhiym\pkcWw ]cntim[nWw.3. tdUntbmfPn sSv A{Smku-v kvIm: hrbpsS henw, GsXnepw apg,

Iv, knv ChbpsS kmnyw Is-m km[npw.am{Xa aq{XXSw, aq{X\mfnbntem aq{Xpgentemaq{Xknbntem Ds-n AXpw Is-pp.hr tcmKnIfn {]tXyInpw ]qambpw {]h\clnXcpsS hrI kvIm\n sNdpXmbn ImWsSpp.

FIvktdIpI Is-m km[npw.Voiding Cystourethrogram.

Intra venous urography (IVU).

aq{Xmibw, \mfn, kn ChbpsS LS\m]camb {]iv\,aq{XXSw, IpI Chsbmw Cu sSneqsS Adnbmkm[n pp.

ap tdUntbmfPn sSpIkn.Sn kvIm, BPntbm{Km^n, Bnt{KUv/dnt{Smt{KbvUvss]tem{Km^n.

4. ap sSpI1. _tbm]vkn.2. knkvtmkvtIm]n.3. bqtdmssU\manIvkv.

14. hrIsf kwcnpI hrtcmK \nbw 15.

bqdnbbpw {Inbmn\n\pw - hr ]pdpc-p aen\ ]ZmfmWv

hr ]qambpw {]h\clnXabmkvIm\n sNdpXmbn ImWsSpp

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hrbpsS _tbm]vkn, ]e hrtcmKfptSbpw ImcWwI-p]nSnm klmbIcamb HmWv.

_tbm]vknHcp kqNn D]tbmKnv hrbnse Hcp tImiw FSpv ssat{ImkvtImneqsS ]cntim[nm hrtcmKns IrXyambImcWw Is-m km[npw.

FtmgmWv hr _tbm]vkn Bhiyambn hcpXv?

Nne tcmKnIfn aq{X]cntim[\bpw c]cntim[\bpw sIm-vtcmK\nbw ]qambpw \Sm km[nn. As\bphcnemWv _tbm]vkn \SpXv.

hrbpsS _tbm]vkn sNp tcmKn a\nemt- Imcy.1. Bip]{Xnbn hp sNp Hcp ]cntim[\bmWv _tbm

]vkn. \nbambpw tcmKnbpsS ]qkXw CXn\hiy amWv.

2. IpnIfn _tbm]vkn ]qambpw abnbXn\ptijtasNpIbpp.

3. tcmKn 612 aWnq hsc hn{ianWw.

3. 34 BgvN hsc `mcap tPmenI HgnhmWw.

_tbm]vkn sNptm dnkvIv Fsmw?

Hcp sNdnb coXnbnsenepw kPdnbpsS AYhm ikv{X {InbbpsS kz`mhap Hcp ]cntim[\bmbXn\m Nnecnsenepw{]iv\ D-mImdp-v.

sNdnb thZ\bpw aq{Xw NphpImWpXpw kzm`mhnIamWv.Fm c{kmhw D-mbm cw sImSppIbpw ho-pwc{kmhw IpdbmsXbpw Ccpm hr Xs \owsNt-Xmbn hcmw. CXp hfsc A]qhamWv.

Nne Ahkcfn H Ahkcn Bhiyn\p tImiwe`nWsan. As\bmsWn _tbm]vkn ho-pwsNt-nhcpw.

16. hrIsf kwcnpI hrtcmK \nbw 17.

_tbm]vkn ]e hrtcmKfptSbpw ImcWwI-p]nSnm klmbnpw

sNdnb thZ\bpw aq{Xw NphpImWpXpwkzm`mhnIamWv

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hrbpsS _tbm]vkn, ]e hrtcmKfptSbpw ImcWwI-p]nSnm klmbIcamb HmWv.

_tbm]vknHcp kqNn D]tbmKnv hrbnse Hcp tImiw FSpv ssat{ImkvtImneqsS ]cntim[nm hrtcmKns IrXyambImcWw Is-m km[npw.

FtmgmWv hr _tbm]vkn Bhiyambn hcpXv?

Nne tcmKnIfn aq{X]cntim[\bpw c]cntim[\bpw sIm-vtcmK\nbw ]qambpw \Sm km[nn. As\bphcnemWv _tbm]vkn \SpXv.

hrbpsS _tbm]vkn sNp tcmKn a\nemt- Imcy.1. Bip]{Xnbn hp sNp Hcp ]cntim[\bmWv _tbm

]vkn. \nbambpw tcmKnbpsS ]qkXw CXn\hiy amWv.

2. IpnIfn _tbm]vkn ]qambpw abnbXn\ptijtasNpIbpp.

3. tcmKn 612 aWnq hsc hn{ianWw.

3. 34 BgvN hsc `mcap tPmenI HgnhmWw.

_tbm]vkn sNptm dnkvIv Fsmw?

Hcp sNdnb coXnbnsenepw kPdnbpsS AYhm ikv{X {InbbpsS kz`mhap Hcp ]cntim[\bmbXn\m Nnecnsenepw{]iv\ D-mImdp-v.

sNdnb thZ\bpw aq{Xw NphpImWpXpw kzm`mhnIamWv.Fm c{kmhw D-mbm cw sImSppIbpw ho-pwc{kmhw IpdbmsXbpw Ccpm hr Xs \owsNt-Xmbn hcmw. CXp hfsc A]qhamWv.

Nne Ahkcfn H Ahkcn Bhiyn\p tImiwe`nWsan. As\bmsWn _tbm]vkn ho-pwsNt-nhcpw.

16. hrIsf kwcnpI hrtcmK \nbw 17.

_tbm]vkn ]e hrtcmKfptSbpw ImcWwI-p]nSnm klmbnpw

sNdnb thZ\bpw aq{Xw NphpImWpXpwkzm`mhnIamWv

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Aymbw 5{][m\ hr tcmKhr tcmKsf AhbpsS kz`mha\pkcnv c-mbn Xcw Xncnmw.

acppsIm-p am{Xw NnInnt- hrtcmK. sNdnb ikv{X{Inb Bhiyw hcp hrtcmK.acpv sIm-v am{Xw \nb{Whnt[bamIm LnUbmennkv Asn hr amnhbv th-n hcpp.

s\t{^mfPnpw bqtdmfPnpw Xnep hyXymkw.

s\t{^mfPnv NnInnpXv bqtdmfPnv NnInnpX v

1. XmXvmenIamb hr kvXw`\w Iv kw_amb tcmKt{]mkvtSv {KnbpsS{]h\ XIcm

2. mbnbmb hr kvXw`\w aq{Xmib kw_ambnP\m D-mIpsshIey

3. aq{Xmibnse AWp_m[ Imk

4. s\t{^mnIv knt{Umw

Acute Renal Failure XmXvImenI hrkvXw`\wAIyqv do\ t^bvenb Ipd v aWnqtdm Znhktfm sIm-vkw`hnmw. a\pjy icocn hrIfpsS {]h\w s]svIpdbp Hcp kmlNcysbmWv XmXvImenI Asn

s]sp-mIp hrkvXw`\w Fp ]dbpXv.Cu kmlNcyn aq{Xns Afhv hmsX Ipdbpp.

{][m\ ImcW c{kmhw (AanXw) AXnkmcw On Xos]m KpcpXcamb lrt{ZmKw Fen\n sUn\n atednb KpcpXcamb AWp_m[ Nne acppI

]mv ISnm (AWen/Viper)

Xkabv tcmKw Is-n NnInnm ]qambpw tcmKwamdmhptXbpp. Nne k`fn Ubmennv XmXvImenIambn sNt-nhcpw. hrbpsS {]h\w Ipdp Znhkpn km[mcWKXnbnemImdp-v.

mbnbmb hrkvXw`\w.\o- Imebfhn amktfm, hjtfm sIm-v {ItaWbmbnD-mIp Hcp tcmKmhbmWnXv. hrbpsS {]h\w]qambpw \nebvp Hcp kmlNcyamWnXv.

{][m\ hr tcmK 19.

Ipdv aWnqtdm Znhktfm sIm-vAIyqv do\ t^bvenb kw`hnmw

Xkabv Is-n NnInnm]qambpw tcmKw amdpw

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Aymbw 5{][m\ hr tcmKhr tcmKsf AhbpsS kz`mha\pkcnv c-mbn Xcw Xncnmw.

acppsIm-p am{Xw NnInnt- hrtcmK. sNdnb ikv{X{Inb Bhiyw hcp hrtcmK.acpv sIm-v am{Xw \nb{Whnt[bamIm LnUbmennkv Asn hr amnhbv th-n hcpp.

s\t{^mfPnpw bqtdmfPnpw Xnep hyXymkw.

s\t{^mfPnv NnInnpXv bqtdmfPnv NnInnpX v

1. XmXvmenIamb hr kvXw`\w Iv kw_amb tcmKt{]mkvtSv {KnbpsS{]h\ XIcm

2. mbnbmb hr kvXw`\w aq{Xmib kw_ambnP\m D-mIpsshIey

3. aq{Xmibnse AWp_m[ Imk

4. s\t{^mnIv knt{Umw

Acute Renal Failure XmXvImenI hrkvXw`\wAIyqv do\ t^bvenb Ipd v aWnqtdm Znhktfm sIm-vkw`hnmw. a\pjy icocn hrIfpsS {]h\w s]svIpdbp Hcp kmlNcysbmWv XmXvImenI Asn

s]sp-mIp hrkvXw`\w Fp ]dbpXv.Cu kmlNcyn aq{Xns Afhv hmsX Ipdbpp.

{][m\ ImcW c{kmhw (AanXw) AXnkmcw On Xos]m KpcpXcamb lrt{ZmKw Fen\n sUn\n atednb KpcpXcamb AWp_m[ Nne acppI

]mv ISnm (AWen/Viper)

Xkabv tcmKw Is-n NnInnm ]qambpw tcmKwamdmhptXbpp. Nne k`fn Ubmennv XmXvImenIambn sNt-nhcpw. hrbpsS {]h\w Ipdp Znhkpn km[mcWKXnbnemImdp-v.

mbnbmb hrkvXw`\w.\o- Imebfhn amktfm, hjtfm sIm-v {ItaWbmbnD-mIp Hcp tcmKmhbmWnXv. hrbpsS {]h\w]qambpw \nebvp Hcp kmlNcyamWnXv.

{][m\ hr tcmK 19.

Ipdv aWnqtdm Znhktfm sIm-vAIyqv do\ t^bvenb kw`hnmw

Xkabv Is-n NnInnm]qambpw tcmKw amdpw

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t cmKeW1. hninembva2. \ocv3. Hmm\w4. Db ckw

mbnbmb hrkvXw`\n c-p {][m\ ImcWfmbn{]talhpw ckhpw IWmsSpp. aq{Xnt{]mo\ns Awiw, cn {Inbmn\ns Afhv {IamXoXambnIqSpI, kvIm\n hr NpcpnbXmbn ImWsSpI CuImcy sSneqsS hyambm hrkvXw`\nsAhbmbn IWmmw. Fm F{Xtmfw hr kvXw`npFv Adnbm Serum Creatinines Afhv ]cntim[nWw.

mbnbmb hr kvXw`\ns BZyLn acppw `W{IaoIcWhpw \ntinsSpp. hrkvXw`\w 90% AsnAXne[nItam BIptmgmWv tcmKnI Ubmennkns\B{ibnt-n hcpXv.

hrkvXw`\w 25%, 30%, 50%, 75% BImw. B Ahbn Ignbp{Xbpw NntbmsS acppw `Whpw {IaoIcnm Hcfhphsc tcmKns thKnep ]ptcmKXnsb XSbmw. 90%ne[nIw BIptm End stage renal disease Fp ]dbpp.

Cu Ahbn 3 amta tcmKnbpsS apnepq.1. lotamUbmennkv2. s]cntmWnb Ubmennkv3. {Smkvmtj

lotamUbmennvHcp {]tXyI D]IcWamb sajo\pw Ir{Xna hrbpap]tbmKnvtcmKnbpsS cw ipoIcnp {]{InbbmWnXv. Hcp ]nsklmbtmsS tcmKnbpsS kncIfn \nv cw ]pdsSpvIr{Xna hr F AcnbneqsS ISn hnSpp. cnXn \np amen\y Cu hr Acnp ampp. ipambcw tcmKnbntev Xncnv \Ipp. Hcp Znhkw 34 aWnqhsc, BgvNbn ct-m aqtm Znhkw, Cu NnIn sNt-nhcpw.F{X Ubmennkv Hcp tcmKnbvv thWw FXv tUmIvSdpsSXocpam\amWv. ]e LSI, tcmKnbpsS imcocnI Ah,Chsbmw B{ibnmbncnpw Cu Xocpam\w. tcmKn kzwCjvS{]Imcw Ubmennkv IqpItbm, IpdbvpItbm sNm]mSpX.s]cntmWnb Ubmennkvhon sNp UbmennkmWv s]cntmWnb Ubmennkv. Hcpmnv Syq_v tcmKnbpsS DZcn Xpntp hbvpp.Cu Syq_neqsS AWphnapamb Hcp {ZmhIw hbdn\ItbvvISn hnSpp. tcmKnbpsS cn \np amen\yfpwAanXPehpw s]cntmWnb sa{bn hgn {ZmhIntebvvhp tNcpp. 34 aWnq Ignbptm amen\y \ndCu {ZmhIw ]pdtbvv Ifbpp. Cu {]{Inb Znhkhpw \mep{]mhiyw sNt-n hcpp. CXv tcmKntm _ptm]TnXn\ptijw hon sNmhp HmWv. tUmIvSdpsS\nti Cu Imcyn ]qambpw ]ment-XmWv.hr amn hbv\nehn hv Ghpw A`nImayamb {]Xnhn[nbmWv hramnhbv. A\ptbmPyamb _pfpsS ]q kXtmsS{]h\aXbp hr tcmKnbntev hbvsSpp.

20. hrIsf kwcnpI {][m\ hr tcmK 21.

hrkvXw`\w 90% Asn AXne[nItam BIptmtcmKnI Ubmennkns\ B{ibnt-nhcpw

tcmKn kzw CjvS{]Imcw Ubmennkv IqpItbm,IpdbvpItbm sNm ]mSpX

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t cmKeW1. hninembva2. \ocv3. Hmm\w4. Db ckw

mbnbmb hrkvXw`\n c-p {][m\ ImcWfmbn{]talhpw ckhpw IWmsSpp. aq{Xnt{]mo\ns Awiw, cn {Inbmn\ns Afhv {IamXoXambnIqSpI, kvIm\n hr NpcpnbXmbn ImWsSpI CuImcy sSneqsS hyambm hrkvXw`\nsAhbmbn IWmmw. Fm F{Xtmfw hr kvXw`npFv Adnbm Serum Creatinines Afhv ]cntim[nWw.

mbnbmb hr kvXw`\ns BZyLn acppw `W{IaoIcWhpw \ntinsSpp. hrkvXw`\w 90% AsnAXne[nItam BIptmgmWv tcmKnI Ubmennkns\B{ibnt-n hcpXv.

hrkvXw`\w 25%, 30%, 50%, 75% BImw. B Ahbn Ignbp{Xbpw NntbmsS acppw `Whpw {IaoIcnm Hcfhphsc tcmKns thKnep ]ptcmKXnsb XSbmw. 90%ne[nIw BIptm End stage renal disease Fp ]dbpp.

Cu Ahbn 3 amta tcmKnbpsS apnepq.1. lotamUbmennkv2. s]cntmWnb Ubmennkv3. {Smkvmtj

lotamUbmennvHcp {]tXyI D]IcWamb sajo\pw Ir{Xna hrbpap]tbmKnvtcmKnbpsS cw ipoIcnp {]{InbbmWnXv. Hcp ]nsklmbtmsS tcmKnbpsS kncIfn \nv cw ]pdsSpvIr{Xna hr F AcnbneqsS ISn hnSpp. cnXn \np amen\y Cu hr Acnp ampp. ipambcw tcmKnbntev Xncnv \Ipp. Hcp Znhkw 34 aWnqhsc, BgvNbn ct-m aqtm Znhkw, Cu NnIn sNt-nhcpw.F{X Ubmennkv Hcp tcmKnbvv thWw FXv tUmIvSdpsSXocpam\amWv. ]e LSI, tcmKnbpsS imcocnI Ah,Chsbmw B{ibnmbncnpw Cu Xocpam\w. tcmKn kzwCjvS{]Imcw Ubmennkv IqpItbm, IpdbvpItbm sNm]mSpX.s]cntmWnb Ubmennkvhon sNp UbmennkmWv s]cntmWnb Ubmennkv. Hcpmnv Syq_v tcmKnbpsS DZcn Xpntp hbvpp.Cu Syq_neqsS AWphnapamb Hcp {ZmhIw hbdn\ItbvvISn hnSpp. tcmKnbpsS cn \np amen\yfpwAanXPehpw s]cntmWnb sa{bn hgn {ZmhIntebvvhp tNcpp. 34 aWnq Ignbptm amen\y \ndCu {ZmhIw ]pdtbvv Ifbpp. Cu {]{Inb Znhkhpw \mep{]mhiyw sNt-n hcpp. CXv tcmKntm _ptm]TnXn\ptijw hon sNmhp HmWv. tUmIvSdpsS\nti Cu Imcyn ]qambpw ]ment-XmWv.hr amn hbv\nehn hv Ghpw A`nImayamb {]Xnhn[nbmWv hramnhbv. A\ptbmPyamb _pfpsS ]q kXtmsS{]h\aXbp hr tcmKnbntev hbvsSpp.

20. hrIsf kwcnpI {][m\ hr tcmK 21.

hrkvXw`\w 90% Asn AXne[nItam BIptmtcmKnI Ubmennkns\ B{ibnt-nhcpw

tcmKn kzw CjvS{]Imcw Ubmennkv IqpItbm,IpdbvpItbm sNm ]mSpX

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Aymbw 6hr tcmKw anYym [mcWIhrsbpdnpw hrtcmKsfpdnpw \nehnep

sXmb Asn anYym[mcWI.

1. Fm hrtcmKfpw amcIamWv.D. A ap`mKfn kqNnnXpt]mse hrtcmKwt\cs Is-n NnInnm amcIamIpIbn.

2. Hcp hr am{Xw XIcmdnembm hr kvXw`\w kw`hnpw.D. Hcp hr am{Xw XIcmdnembmepw cn amen\ywIpanp IqSpn. {]h\ aXbp hramen\ysf \ow sNpp.

3. hr tcmKnIfn \ocv D-mIptm hr kvXw`\skqNnnpp.D. Nne hr tcmKfn \ocv D-mImdp-v. Fm hr]qambpw \nep Fv CXn\an.

4. \ocv Fm hrtcmKnIfnepw ImWsSpp.D. Fm hrtcmKpw \ocv D-mIWsav\n_an. Hmtcm tcmKnbpsS LS\b\pkcnv amImWmw. hrkvXw`\w D Nne tcmKnIfn \ocv ImWmdn.AXn\m \ocnm hynbvv hrtcmKw CFan.

5. hrtcmKnI [mcmfw shw IpSnbvWw.D. AcpX.v aq{Xw t]mImsX \osv hr tcmKnIfnD-mIpp. AXn\m IqSpX shw sImSpm

IqSpX aq{Xw t]mIpIbn. am{Xhpa shw {]tXyIambn\nb{nm am{Xsa icocnse Pemwins kpenXmh \ne\npIbpp. Fm aq{XmibnseIv, AWp_m[ XpSnb {]iv\v IqSpX shwIpSnWw.

6. F\nv {]tXyInv Ipgsampan. AXpsIm-v F\nvhy tcmKan.D. an Bmcnepw Hcp _mly eWfpw D-mImdn.em_v ]cntim[\bn am{Xsa Cu Imcyn hyX\Im\mIq.

7. F\nv kpJw D-v. AXn\m C\n NnIn XpStc-Bhiyan.D. NnIn apSpXv hfsc A]ISIcamWv. hrkvXw`\w kw`hn tcmKnIv acppw `W\nb{Whpw sIm-v {IaoIcnt- NnInmhn[n s]svaqnv Ubmennv hsc Fntbmw.

8. Fs skdw {Inbmn\n Hcev]w am{Xsa IqSnbnpffp.AmsX ap {]iv\sfmpan.D. sNdnb hyXymkw skdw {Inbmn\n\n hm AXv hrXIcmdns eWw BWv. Hcp hr tcmKhnZKvZs\ CuLn I-ncnWw. skdw {Inbmn\n 1.6 Bbm 50%am{Xsa hr {]h\w Dp. FXm-v 5.0 Bbn{Inbmn\n Dbm 80% {]h\hpw \nencnpwFw. 10 BIptm 95% hrbpsS {]h\hpw\nencnpw. Cu Ahbn acppsIm-p NnIn^e{]ZamIpIbn. Ubmennkv am{Xw BIpp ]nsamw.

hr tcmKw anYym [mcWI 23.

Fm hrtcmKpw \ocv D-mIWsan NnIn apSpXv hfsc A]ISIcamWv

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Aymbw 6hr tcmKw anYym [mcWIhrsbpdnpw hrtcmKsfpdnpw \nehnep

sXmb Asn anYym[mcWI.

1. Fm hrtcmKfpw amcIamWv.D. A ap`mKfn kqNnnXpt]mse hrtcmKwt\cs Is-n NnInnm amcIamIpIbn.

2. Hcp hr am{Xw XIcmdnembm hr kvXw`\w kw`hnpw.D. Hcp hr am{Xw XIcmdnembmepw cn amen\ywIpanp IqSpn. {]h\ aXbp hramen\ysf \ow sNpp.

3. hr tcmKnIfn \ocv D-mIptm hr kvXw`\skqNnnpp.D. Nne hr tcmKfn \ocv D-mImdp-v. Fm hr]qambpw \nep Fv CXn\an.

4. \ocv Fm hrtcmKnIfnepw ImWsSpp.D. Fm hrtcmKpw \ocv D-mIWsav\n_an. Hmtcm tcmKnbpsS LS\b\pkcnv amImWmw. hrkvXw`\w D Nne tcmKnIfn \ocv ImWmdn.AXn\m \ocnm hynbvv hrtcmKw CFan.

5. hrtcmKnI [mcmfw shw IpSnbvWw.D. AcpX.v aq{Xw t]mImsX \osv hr tcmKnIfnD-mIpp. AXn\m IqSpX shw sImSpm

IqSpX aq{Xw t]mIpIbn. am{Xhpa shw {]tXyIambn\nb{nm am{Xsa icocnse Pemwins kpenXmh \ne\npIbpp. Fm aq{XmibnseIv, AWp_m[ XpSnb {]iv\v IqSpX shwIpSnWw.

6. F\nv {]tXyInv Ipgsampan. AXpsIm-v F\nvhy tcmKan.D. an Bmcnepw Hcp _mly eWfpw D-mImdn.em_v ]cntim[\bn am{Xsa Cu Imcyn hyX\Im\mIq.

7. F\nv kpJw D-v. AXn\m C\n NnIn XpStc-Bhiyan.D. NnIn apSpXv hfsc A]ISIcamWv. hrkvXw`\w kw`hn tcmKnIv acppw `W\nb{Whpw sIm-v {IaoIcnt- NnInmhn[n s]svaqnv Ubmennv hsc Fntbmw.

8. Fs skdw {Inbmn\n Hcev]w am{Xsa IqSnbnpffp.AmsX ap {]iv\sfmpan.D. sNdnb hyXymkw skdw {Inbmn\n\n hm AXv hrXIcmdns eWw BWv. Hcp hr tcmKhnZKvZs\ CuLn I-ncnWw. skdw {Inbmn\n 1.6 Bbm 50%am{Xsa hr {]h\w Dp. FXm-v 5.0 Bbn{Inbmn\n Dbm 80% {]h\hpw \nencnpwFw. 10 BIptm 95% hrbpsS {]h\hpw\nencnpw. Cu Ahbn acppsIm-p NnIn^e{]ZamIpIbn. Ubmennkv am{Xw BIpp ]nsamw.

hr tcmKw anYym [mcWI 23.

Fm hrtcmKpw \ocv D-mIWsan NnIn apSpXv hfsc A]ISIcamWv

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9. Hcn hrIcmdn\v Ubmennkv sNbvXm Bbppapgph AXv sNt-nhcpw.D. GXv Xcw hrtcmKw FXns\ B{ibnncnpw.mbnbmb hr tcmKw DhmWv \nXyambUbmennkv Bhiyw hcpXv.XmXvImenI hrkvXw`\n CXv Bhiyambn hcpn.Ubmennkv `bv AXv sNpXn Xmakwhcpptm ap Ahbhpw tISp]mSv kw`hnmw.AXn\m hnZKvZcpsS A`n{]mbw am\nv tcmKn AXn\pXmdmIWw.

10. hrtcmKw Ubmennkv sNbvXm amdpw.D. C. UbmennkneqsS icocnse amen\y ]pdpIfbpp. icocn hrbvv Cu tPmen sNm\mhmsXhcptmgmWv Ubmennkv sNpXv. AXn\m Ubmennkv Hcp tcmKhnapn ama. adnv XmXvImenIambnhrbvp ]Icw {]h\w \Sp Hcp {]{Inbam{XamWv.

11. hr Zm\w sNpXv BtcmKytbpw ssewKoI PohnXsbpw _m[npw.D. sXv. Hcnepan. BtcmKyhpw ssewKoI PohnXhpwam{Xhpa IeymWw, {]khw Chsbmpw Hcp hr ZmXmhns\ {]XnIqeambn _m[nn.

12. hy amn hbven\p hr hmm km[npw.D. hr hmpXpw hnpXpw IpIcamWv. Pohnncnp _phn \nv amnhbvsSp hrtbm

_phm BfpsS hr FpsIm-pw XnckvcnsSm D km[yX hfsc IqSpXemWv.

13. Fs _n.]n. t\ma BWv. AXpsIm-v F\nbvvacpns Bhiyan.D. ckw Hcp hn\mWv. acpv Ignptm Ipdbpckw acpv \nptm IqSpIbpw sNpp.AXn\m ckaph acpv IrXyambnIgnnsn hrsb am{Xa Xetmdnt\bpw_m[npp.

14. ]pcpjmpw am{Xw Hcp knbn Imens CSbnhr nXn sNpp.D. DZcn\pn \sns Ccp`mKpambn Ghpw]ndInembmWv hr nXnsNpXv. kv{Xobnepw]pcpj\nepw hr Htc emWv nXn sNpXv.

]pcpjmcn Imen\nSbn ImWp kn hrjvWamWv.{]Xypev]mZ\ {]{Inbbn CXv {][m\ ]p hlnpp.

24. hrIsf kwcnpI hr tcmKw anYym [mcWI 25.

mbnbmb hr tcmKw DhmWv \nXyambUbmennkv Bhiyw hcpXv

acpv Ignptm Ipdbp ckw acpv\nptm IqSpIbpw sNpp

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9. Hcn hrIcmdn\v Ubmennkv sNbvXm Bbppapgph AXv sNt-nhcpw.D. GXv Xcw hrtcmKw FXns\ B{ibnncnpw.mbnbmb hr tcmKw DhmWv \nXyambUbmennkv Bhiyw hcpXv.XmXvImenI hrkvXw`\n CXv Bhiyambn hcpn.Ubmennkv `bv AXv sNpXn Xmakwhcpptm ap Ahbhpw tISp]mSv kw`hnmw.AXn\m hnZKvZcpsS A`n{]mbw am\nv tcmKn AXn\pXmdmIWw.

10. hrtcmKw Ubmennkv sNbvXm amdpw.D. C. UbmennkneqsS icocnse amen\y ]pdpIfbpp. icocn hrbvv Cu tPmen sNm\mhmsXhcptmgmWv Ubmennkv sNpXv. AXn\m Ubmennkv Hcp tcmKhnapn ama. adnv XmXvImenIambnhrbvp ]Icw {]h\w \Sp Hcp {]{Inbam{XamWv.

11. hr Zm\w sNpXv BtcmKytbpw ssewKoI PohnXsbpw _m[npw.D. sXv. Hcnepan. BtcmKyhpw ssewKoI PohnXhpwam{Xhpa IeymWw, {]khw Chsbmpw Hcp hr ZmXmhns\ {]XnIqeambn _m[nn.

12. hy amn hbven\p hr hmm km[npw.D. hr hmpXpw hnpXpw IpIcamWv. Pohnncnp _phn \nv amnhbvsSp hrtbm

_phm BfpsS hr FpsIm-pw XnckvcnsSm D km[yX hfsc IqSpXemWv.

13. Fs _n.]n. t\ma BWv. AXpsIm-v F\nbvvacpns Bhiyan.D. ckw Hcp hn\mWv. acpv Ignptm Ipdbpckw acpv \nptm IqSpIbpw sNpp.AXn\m ckaph acpv IrXyambnIgnnsn hrsb am{Xa Xetmdnt\bpw_m[npp.

14. ]pcpjmpw am{Xw Hcp knbn Imens CSbnhr nXn sNpp.D. DZcn\pn \sns Ccp`mKpambn Ghpw]ndInembmWv hr nXnsNpXv. kv{Xobnepw]pcpj\nepw hr Htc emWv nXn sNpXv.

]pcpjmcn Imen\nSbn ImWp kn hrjvWamWv.{]Xypev]mZ\ {]{Inbbn CXv {][m\ ]p hlnpp.

24. hrIsf kwcnpI hr tcmKw anYym [mcWI 25.

mbnbmb hr tcmKw DhmWv \nXyambUbmennkv Bhiyw hcpXv

acpv Ignptm Ipdbp ckw acpv\nptm IqSpIbpw sNpp

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Aymbw 7hrtcmKs Fs\ XSbmw?hr tcmKw Fs\ XSbmw?

hrtcmKw ]Xpnbncnp Hcp sImebmfnpXpeyamWv. Hcn {]h\aX Ipdm Imew sNpwtXmdpw AXv hnpIbpw tcmKnbvv Ubmenntm hramnhbvtem th-n hcnIbpw sNpp. Fnepw IrXyambnsImn Hcn tcmKansn IqSn Hcp hrhnZKvZs\sm-p ]cntim[nnt-Xv AXymhiyamWv. hfsct\cs tcmKspdnv kqN\I e`nm tcmKns]ptcmKXnsb XSbm\pw Xqew imcocnIhpw am\nIhpwkmnIhpamb _m[yXI Hgnhmm\pw klmbnpw. hrtcmKn\v \nehn {]Xnhn[nbn. Fm t\csIs-nbm app ]dXpt]mse Ubmennv hscFmsX \nb{nmw.

BtcmKyhm\mb B hrsb Fs\ kwcnpw?Ggp \nti AXn\mbn \IsSpp.

1 . \nXyhpw hymbmaw sNpI. CXv cksbpw{]taltbpw Hcp ]cn[n hsc XSbpw, Xqew hrtcmKsbpw AIn \nmw.

2 . `Ww: Blmc coXn hfsc {][m\amWv. ]ghw,\mcSnb ` Ww, ]dnI IqSpXembn D]tbmKnmw.

Cdn. ap, ssaZ, Dns AanXamb D]tbmKw ChsbmwIpdbvpI. 40 hbn\ptijw D v IpdbvpXv hrtcmKsbpw hrbnse IpItfbpw Hcp ]cn[n hsc AIn\npw.

3. Xqw \nb{npI: `mcw AanXambn IqSmsX icnbmb`WneqsSbpw icnbmb hymbmaneqsSbpw icoc`mcw\nb{npI.

4. ] pIhe n : ]pIbnebpsS D]tbmKw Ch Dhcnhrbntebvp ctbmw Ipdbpp. kzm`mhnIambpwhrbpsS {]h\w Ipdbpp.

5. thZ\ kwlmcnI: \nXyhpw Ch IgnpXv HgnhmpI.Ch ncambn IgnpXv hrIv tISp-mpw. thZ\kwlmcn \nXyhpw Ignt-n hcph Hcp hr hnZKvZs\IqSn I-v A`n{]mbw kzoIcnWw.

6 [mcmfw shw IpSnpI: 3 en shw IpSnptmaq{Xns km{X Ipdv amen\y Fmw Xs]pdn hr IpIsf XSbpp.

7 IrXyamb ]cntim[\I: hrtcmKw _mly eWFmbvtmgpw {]ISnnmXn\m hrsb IrXyamb]cntim[\v hnt[bamWw. chpw aq{Xhpw ]cntim[n vXIcmdps-n BZyta Xs \nb{W hnt[bammw.hrtcmK]mccyaph, ckaph AanXhw,{]talw hrIv Chbph {]tXyIw {inWw. 40hbn\p apIfn Xobmbpw ]cntim[\I \SWw.

hrtcmKs Fs\ XSbmw? 27.

hfsc t\cs tcmKspdnv kqN\I e`nmtcmKns ]ptcmKXnsb \nb{nmw

thZ\kwlmcnI \nXyhpw IgnpXv HgnhmpI

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Aymbw 7hrtcmKs Fs\ XSbmw?hr tcmKw Fs\ XSbmw?

hrtcmKw ]Xpnbncnp Hcp sImebmfnpXpeyamWv. Hcn {]h\aX Ipdm Imew sNpwtXmdpw AXv hnpIbpw tcmKnbvv Ubmenntm hramnhbvtem th-n hcnIbpw sNpp. Fnepw IrXyambnsImn Hcn tcmKansn IqSn Hcp hrhnZKvZs\sm-p ]cntim[nnt-Xv AXymhiyamWv. hfsct\cs tcmKspdnv kqN\I e`nm tcmKns]ptcmKXnsb XSbm\pw Xqew imcocnIhpw am\nIhpwkmnIhpamb _m[yXI Hgnhmm\pw klmbnpw. hrtcmKn\v \nehn {]Xnhn[nbn. Fm t\csIs-nbm app ]dXpt]mse Ubmennv hscFmsX \nb{nmw.

BtcmKyhm\mb B hrsb Fs\ kwcnpw?Ggp \nti AXn\mbn \IsSpp.

1 . \nXyhpw hymbmaw sNpI. CXv cksbpw{]taltbpw Hcp ]cn[n hsc XSbpw, Xqew hrtcmKsbpw AIn \nmw.

2 . `Ww: Blmc coXn hfsc {][m\amWv. ]ghw,\mcSnb ` Ww, ]dnI IqSpXembn D]tbmKnmw.

Cdn. ap, ssaZ, Dns AanXamb D]tbmKw ChsbmwIpdbvpI. 40 hbn\ptijw D v IpdbvpXv hrtcmKsbpw hrbnse IpItfbpw Hcp ]cn[n hsc AIn\npw.

3. Xqw \nb{npI: `mcw AanXambn IqSmsX icnbmb`WneqsSbpw icnbmb hymbmaneqsSbpw icoc`mcw\nb{npI.

4. ] pIhe n : ]pIbnebpsS D]tbmKw Ch Dhcnhrbntebvp ctbmw Ipdbpp. kzm`mhnIambpwhrbpsS {]h\w Ipdbpp.

5. thZ\ kwlmcnI: \nXyhpw Ch IgnpXv HgnhmpI.Ch ncambn IgnpXv hrIv tISp-mpw. thZ\kwlmcn \nXyhpw Ignt-n hcph Hcp hr hnZKvZs\IqSn I-v A`n{]mbw kzoIcnWw.

6 [mcmfw shw IpSnpI: 3 en shw IpSnptmaq{Xns km{X Ipdv amen\y Fmw Xs]pdn hr IpIsf XSbpp.

7 IrXyamb ]cntim[\I: hrtcmKw _mly eWFmbvtmgpw {]ISnnmXn\m hrsb IrXyamb]cntim[\v hnt[bamWw. chpw aq{Xhpw ]cntim[n vXIcmdps-n BZyta Xs \nb{W hnt[bammw.hrtcmK]mccyaph, ckaph AanXhw,{]talw hrIv Chbph {]tXyIw {inWw. 40hbn\p apIfn Xobmbpw ]cntim[\I \SWw.

hrtcmKs Fs\ XSbmw? 27.

hfsc t\cs tcmKspdnv kqN\I e`nmtcmKns ]ptcmKXnsb \nb{nmw

thZ\kwlmcnI \nXyhpw IgnpXv HgnhmpI

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hrtcmKap B hrtcmKs Fs\ ssIImcywsNpw?1 . hrsbpdnpw, hrtcmKsfpdnpw Aht_m

[w D-mIWw.hrtcmKs Ipdnv Adnhpbm _mly eWamb\ocv, On, hbnfw, hninmbva, aq{Xtmv, aq{Xncw Ch I-m DS\Sn hrtcmKhnZKvZs\ kao]npI.

2. {]talaph {int- ImcyhrtcmKns {][m\ ImcWambn {]talwIWmsSpp. 45% mbnbmb hr kvXw`\nsXpSw {]taln \nmWv.{]taltcmKn Fm hjhpw chpw aq{Xhpw ]cntim[nvaq{Xn t{]mos kmnyw C Fv DdphcpWw.cn {Inbmn\ns Afhpw XnsSpWw.{]taltcmKn Blmc{Ian sImgpntbpw t{]mo\ntbpw Afhv \nb{nWw.

3. ckaphhrtcmKns c-mas {][m\ ImcWambncks I-phcpp. ckaphacpns D]tbmKneqsS AXns\ \nb{nptmAXp XpScphm\pw {]tXyIw {inWw. ckwIpdm acpv \nphm\p Hcp {]hWX I-phcpp. CX]ISw Wnp hcppXn\p XpeyamWv.ckap hyn Dns Afhv IpdbvWw.

ckw 130/80 bn Xmsg \ndpphm {inWw.aq{X]cntim[\bpw c]cntim[\bpw \Sn{Inbmddn\ntbpw t{]mn\ntbpw Afhv XnsSWw.

4. mbnbmb hrkvXw`\w hcmXncnm FSpt-apIcpXepIhrtcmKw ]qambpw t`Zamm Cv Hcp NnInbpw\nehn. Fm hrtcmKns BZyLn XsAXns\ Is-n NnInnm tcmKs\nb{Whnt[bammw.ckw, {]talw Chbph AXn\p NnInt\SpI. 40 hbn\p apIfneph hjn Hcp{]mhiyw chpw aq{Xhpw ]cntim[npI. ckw130/80 Xmsg \npI. ]q BtcmKyhm\mb Hcmfpwckw 130/80 Xmsg \nm {inWw.

5. t]mfnknnIv hr tcmKw]mccyambn D-mIp Hcp hr tcmKamWv t]mfnknnIvInUv\n Unkokv. Ubmennkv sNp tcmKnIfn 68%hsc Cu hr tcmKw _m[nhcmWv.t]mfnnnIv InUv\n tcmKw hon amsnepaps-nXobmbpw Hcp kvIm\neqsS CXpt-m Ctbm FvXnsSpWw.tcmKhnapn Csnepw aq{Xmib AWp_m[,ckw, {]talw Blmc{Iaw Chsbmw \nb{nmhrbvp-mIp XIcm Ipdbvm km[nbvpw.

28. hrIsf kwcnpI hrtcmKs Fs\ XSbmw? 29.

hrtcmKns {][m\ ImcWw {]talamWv ckw 130/80 Xmsg \npI

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hrtcmKap B hrtcmKs Fs\ ssIImcywsNpw?1 . hrsbpdnpw, hrtcmKsfpdnpw Aht_m

[w D-mIWw.hrtcmKs Ipdnv Adnhpbm _mly eWamb\ocv, On, hbnfw, hninmbva, aq{Xtmv, aq{Xncw Ch I-m DS\Sn hrtcmKhnZKvZs\ kao]npI.

2. {]talaph {int- ImcyhrtcmKns {][m\ ImcWambn {]talwIWmsSpp. 45% mbnbmb hr kvXw`\nsXpSw {]taln \nmWv.{]taltcmKn Fm hjhpw chpw aq{Xhpw ]cntim[nvaq{Xn t{]mos kmnyw C Fv DdphcpWw.cn {Inbmn\ns Afhpw XnsSpWw.{]taltcmKn Blmc{Ian sImgpntbpw t{]mo\ntbpw Afhv \nb{nWw.

3. ckaphhrtcmKns c-mas {][m\ ImcWambncks I-phcpp. ckaphacpns D]tbmKneqsS AXns\ \nb{nptmAXp XpScphm\pw {]tXyIw {inWw. ckwIpdm acpv \nphm\p Hcp {]hWX I-phcpp. CX]ISw Wnp hcppXn\p XpeyamWv.ckap hyn Dns Afhv IpdbvWw.

ckw 130/80 bn Xmsg \ndpphm {inWw.aq{X]cntim[\bpw c]cntim[\bpw \Sn{Inbmddn\ntbpw t{]mn\ntbpw Afhv XnsSWw.

4. mbnbmb hrkvXw`\w hcmXncnm FSpt-apIcpXepIhrtcmKw ]qambpw t`Zamm Cv Hcp NnInbpw\nehn. Fm hrtcmKns BZyLn XsAXns\ Is-n NnInnm tcmKs\nb{Whnt[bammw.ckw, {]talw Chbph AXn\p NnInt\SpI. 40 hbn\p apIfneph hjn Hcp{]mhiyw chpw aq{Xhpw ]cntim[npI. ckw130/80 Xmsg \npI. ]q BtcmKyhm\mb Hcmfpwckw 130/80 Xmsg \nm {inWw.

5. t]mfnknnIv hr tcmKw]mccyambn D-mIp Hcp hr tcmKamWv t]mfnknnIvInUv\n Unkokv. Ubmennkv sNp tcmKnIfn 68%hsc Cu hr tcmKw _m[nhcmWv.t]mfnnnIv InUv\n tcmKw hon amsnepaps-nXobmbpw Hcp kvIm\neqsS CXpt-m Ctbm FvXnsSpWw.tcmKhnapn Csnepw aq{Xmib AWp_m[,ckw, {]talw Blmc{Iaw Chsbmw \nb{nmhrbvp-mIp XIcm Ipdbvm km[nbvpw.

28. hrIsf kwcnpI hrtcmKs Fs\ XSbmw? 29.

hrtcmKns {][m\ ImcWw {]talamWv ckw 130/80 Xmsg \npI

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6. IpnIp-mIp aq{Xmibnse AWp_m[Hcp Ipnbvv AImcWambn ]\n, aq{Xw IqsSIqsSt]mIpI, aq{XpSnn hninmbva, `mcw IqSmsXbncnpI ChbntesXnepw Ds-n Hcp bqtdmfPnns\ImWnv NnIn tXSWw.]\ntbmSpIqSnb aq{Xmib AWp_m[ hrsbA]ISsSpntbmw. Ccw AWp_m[I hrbn]mSpI, hrbpsS hfpdhv ckwhrkvXw`\w Chbntev \bntpw. AXn\m IpnIp-mIp aq{Xmib AWp_m[ {i Alnpp.

7. henbhcn D-mIp aq{Xnse AWp_m[acpp Ignnpw XpSscXpSsc hm AXns ImcWwIs-t- Bhiyw hcpp. hrsb kwcnmImcWw Adnm am{Xsa km[nq.

8. hrbnse Ivhrbnse Iv thZ\bpfhmptmgmWv {insSpXv.IpI _pnapv D-mpIbmsWn amnbm aXn.Fm A{i hrIcmdntev \bnmw. AXn\mBhiym\pkcWw ]cntim[\ \SWw.

9. sNdnb {]mbnse cks \nmcambnImWcpXv.hrtcmKfmImw sNdp{]mbn Db ckwD-mpXv. AXn\m Db ckw Is-nbm AXns ImcWw IqSn Is-n NnInnt-Xp-v. CXv {inm hrtcmKmhbn \nv tamN\wt\Smw.

10. XmXvImenI hrkvXw`\w Xkabv NnInnpI.AXnkmcw, On, kZi\w, atednb, AWp_m[Chsbms XmXvImenI hrkwXw`\n\v ImcWamtbmw. Fm acppw ap Bhiyap NnInbpwsNbvXm hr ]q nXnbn {]hnpw.

11 . acppI D]tbmKnptm {inpI.]etmgpw acpns Zqjy^e AdnbmsX, AhbpsSBhiyw Dt-m Ctbm FdnbmsX AXv GsXnepwsaUn tmdpIfn \nv hmn D]tbmKnsSpp.kzbw NnIn \SpXv Xopw HgnhmpI. Hmtcmacppw icocn Bhiyne[nIw sNm AXn\vZqjy^e It-mw. {]tXyInv thZ\ kwlmcnI.AXn\m acppI tUmIvSdpsS D]tZi{]Imcw am{XwD]tbmKnpI.

12. H hrbp hynBtcmKytmsS PohnXw \bnphm H hr Hcp XSa.Fm ckw \nb{Whnt[bamtWm FvCSbvv ]cntim[npXv \mbncnpw. `W{Iaw,Dns Afhv, t{]mo AanXambn D]tbmKnmXncnpICsXmw {inv IrXyambn sNpI \Snbm\mbncnpw.c-p hrbpsS tPmen Hcp hr GsSppXn\m {iBhiyamWv.

30. hrIsf kwcnpI hrtcmKs Fs\ XSbmw? 31.

IpnIp-mIp aq{Xmib AWp_m[{i Alnpp

BtcmKytmsS PohnXw \bnphmH hr Hcp XSa

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6. IpnIp-mIp aq{Xmibnse AWp_m[Hcp Ipnbvv AImcWambn ]\n, aq{Xw IqsSIqsSt]mIpI, aq{XpSnn hninmbva, `mcw IqSmsXbncnpI ChbntesXnepw Ds-n Hcp bqtdmfPnns\ImWnv NnIn tXSWw.]\ntbmSpIqSnb aq{Xmib AWp_m[ hrsbA]ISsSpntbmw. Ccw AWp_m[I hrbn]mSpI, hrbpsS hfpdhv ckwhrkvXw`\w Chbntev \bntpw. AXn\m IpnIp-mIp aq{Xmib AWp_m[ {i Alnpp.

7. henbhcn D-mIp aq{Xnse AWp_m[acpp Ignnpw XpSscXpSsc hm AXns ImcWwIs-t- Bhiyw hcpp. hrsb kwcnmImcWw Adnm am{Xsa km[nq.

8. hrbnse Ivhrbnse Iv thZ\bpfhmptmgmWv {insSpXv.IpI _pnapv D-mpIbmsWn amnbm aXn.Fm A{i hrIcmdntev \bnmw. AXn\mBhiym\pkcWw ]cntim[\ \SWw.

9. sNdnb {]mbnse cks \nmcambnImWcpXv.hrtcmKfmImw sNdp{]mbn Db ckwD-mpXv. AXn\m Db ckw Is-nbm AXns ImcWw IqSn Is-n NnInnt-Xp-v. CXv {inm hrtcmKmhbn \nv tamN\wt\Smw.

10. XmXvImenI hrkvXw`\w Xkabv NnInnpI.AXnkmcw, On, kZi\w, atednb, AWp_m[Chsbms XmXvImenI hrkwXw`\n\v ImcWamtbmw. Fm acppw ap Bhiyap NnInbpwsNbvXm hr ]q nXnbn {]hnpw.

11 . acppI D]tbmKnptm {inpI.]etmgpw acpns Zqjy^e AdnbmsX, AhbpsSBhiyw Dt-m Ctbm FdnbmsX AXv GsXnepwsaUn tmdpIfn \nv hmn D]tbmKnsSpp.kzbw NnIn \SpXv Xopw HgnhmpI. Hmtcmacppw icocn Bhiyne[nIw sNm AXn\vZqjy^e It-mw. {]tXyInv thZ\ kwlmcnI.AXn\m acppI tUmIvSdpsS D]tZi{]Imcw am{XwD]tbmKnpI.

12. H hrbp hynBtcmKytmsS PohnXw \bnphm H hr Hcp XSa.Fm ckw \nb{Whnt[bamtWm FvCSbvv ]cntim[npXv \mbncnpw. `W{Iaw,Dns Afhv, t{]mo AanXambn D]tbmKnmXncnpICsXmw {inv IrXyambn sNpI \Snbm\mbncnpw.c-p hrbpsS tPmen Hcp hr GsSppXn\m {iBhiyamWv.

30. hrIsf kwcnpI hrtcmKs Fs\ XSbmw? 31.

IpnIp-mIp aq{Xmib AWp_m[{i Alnpp

BtcmKytmsS PohnXw \bnphmH hr Hcp XSa

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Aymbw 8hrkvXw`\whr-bpsS {][m\ tPmen amen-\y- Acn-p-Ibpw ]pd--p-I-bp-am-Wv. CtXm-sSmw ico-c-n-\m-h-iy-an-m Pew, eh-Ww, Dv,{Zmh-I- Ch-sbmw aq{X-n-eqsS ]pd-tbvv If-bp-IbpwsNpp. hr-kvXw-` \w D-m-Ip-tm aq{X- ns Afhv KWy-ambn Ipd-bp-Ibpw aq{X-ns \ndw amdp-Ibpw sNp-p.IqSmsX bqdn-b-bp-tSbpw Afhv s]p hn-p-Ibpw sNpw.Cu tPmen-I hrbvv sNm km[n-msX hcp Ah-sbhr-kvXw-`\w Fp ]d-bp-p. c-nse {Inbm-n-\n-t-bpwbqdn-b-bp-tSbpw Afhv ]cn-tim-[n-m hrbvv XI-cm Dt-mCtbm Fp nXnco-I-cn-mw.

Hcp hrbvp XI-cmdv hm hrkvXw-` \w D-m-Iptam?

C. Hcp hrbvv XI-cm kw -`hn- m AXns {]-h\wIqSn at hr Gs-Sp-p-p.

hr-kvXw-`\w c-p Xcw

1. XmXvIm-enI hr-kvXw-` \w

2. mbn-bmb hr-kvXw-`\w

XmXvIm-enI hr-kvXw-`\w

ico-c-n hr-I-fpsS {]h\w s]sp Ipd-bp kml-N-cys XmXv -Im-enI h-r kvXw`\w Fp ]d-bpp. s]-sp-mIp Hm-b-Xn-\m X ka-bv NnIn-n-m hr-I-fpsS {]h\w ]g-b-Xp-t]mse hos--Sp-mw.

mbn-bmb hr-kvXw`\w

kmh-[m-\-n \mw Adn-bmsX ]e-Xcw tcmK- aqew \psShr-I ]q-ambpw {]h-\-c-ln-X-am-Imw. XI-cm-dn-em-Iphr ]ns Hcp NnIn--sIm-p t`Z-am-Im Hc-h--bn-se-pp. CXns\ End Stage Kidney Disease -A-Yhm mbn-bmbhr-kvXw-` \w Fp ]d-bp-p.

hrkvXw`\w 33.

Hcp hrbvv XI-cm kw`-hn-m AXns{]-h\w IqSn at hr Gs-Sp -p-p

\mw Adn-bmsX ]e-Xcw tcmK- aqew \psS hr-I]q-ambpw {]h-\-c-ln-X-am-Imw

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Aymbw 8hrkvXw`\whr-bpsS {][m\ tPmen amen-\y- Acn-p-Ibpw ]pd--p-I-bp-am-Wv. CtXm-sSmw ico-c-n-\m-h-iy-an-m Pew, eh-Ww, Dv,{Zmh-I- Ch-sbmw aq{X-n-eqsS ]pd-tbvv If-bp-IbpwsNpp. hr-kvXw-` \w D-m-Ip-tm aq{X- ns Afhv KWy-ambn Ipd-bp-Ibpw aq{X-ns \ndw amdp-Ibpw sNp-p.IqSmsX bqdn-b-bp-tSbpw Afhv s]p hn-p-Ibpw sNpw.Cu tPmen-I hrbvv sNm km[n-msX hcp Ah-sbhr-kvXw-`\w Fp ]d-bp-p. c-nse {Inbm-n-\n-t-bpwbqdn-b-bp-tSbpw Afhv ]cn-tim-[n-m hrbvv XI-cm Dt-mCtbm Fp nXnco-I-cn-mw.

Hcp hrbvp XI-cmdv hm hrkvXw-` \w D-m-Iptam?

C. Hcp hrbvv XI-cm kw -`hn- m AXns {]-h\wIqSn at hr Gs-Sp-p-p.

hr-kvXw-`\w c-p Xcw

1. XmXvIm-enI hr-kvXw-` \w

2. mbn-bmb hr-kvXw-`\w

XmXvIm-enI hr-kvXw-`\w

ico-c-n hr-I-fpsS {]h\w s]sp Ipd-bp kml-N-cys XmXv -Im-enI h-r kvXw`\w Fp ]d-bpp. s]-sp-mIp Hm-b-Xn-\m X ka-bv NnIn-n-m hr-I-fpsS {]h\w ]g-b-Xp-t]mse hos--Sp-mw.

mbn-bmb hr-kvXw`\w

kmh-[m-\-n \mw Adn-bmsX ]e-Xcw tcmK- aqew \psShr-I ]q-ambpw {]h-\-c-ln-X-am-Imw. XI-cm-dn-em-Iphr ]ns Hcp NnIn--sIm-p t`Z-am-Im Hc-h--bn-se-pp. CXns\ End Stage Kidney Disease -A-Yhm mbn-bmbhr-kvXw-` \w Fp ]d-bp-p.

hrkvXw`\w 33.

Hcp hrbvv XI-cm kw`-hn-m AXns{]-h\w IqSn at hr Gs-Sp -p-p

\mw Adn-bmsX ]e-Xcw tcmK- aqew \psS hr-I]q-ambpw {]h-\-c-ln-X-am-Imw

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Aymbw 9XmXvImenI hrkvXw`\wFmWv XmXvImenI hr kvXw`\w?

]e ImcW sIm-pw CXv kw`hnmw. {][m\ ImcWHp {inmw. hrbntebvp ctbmw IpdbpI. AXnkmcw, On,

s]m, cw hmp t]mhpI, ckw XmgpICsXmw sIm-v Pemwiw icocn \nv \jvSsSpIbpwctbmw IpdbpIbpw sNmw.

ISp AWp_m[, amcIamb tcmKw Asn Hcpikv{X{Inbbvptijhpw hrbpsS {]h\w s]spIpdbmw.

aq{XXSw: km[mcW hrpIfmWv CXn\v {][m\XSw.

Fen\n, kZi\w, AanX c{kmhw, sUn\n,KpcpXcamb lrt{ZmKw sk]vknkv (KpcpXcamb AWp_m[),cmkhkvXpfSnb Nne \mpacppI, thZ\kwlmcnI, knhmX NnInbpsS acppI, acppItfmSpAePn.

eWs]sp-mIp hrkvXw`\ns eWfpw As\Xsbmhmw. AXn\m AXv s]sp Xs {ibnsSpp.

aq{Xns Afhv KWyambn IpdbpI. IWmense \ocv,`mcw IqSpI.

hninmbva, On, Xf, oWw, kpt_m[w IpdbpI. izmkw ap, s\pthZ\, tNmc OnpI, lrZbanSnns

Xmfw sXpI, Pn, At_m[mh XpSnb Poh\p`ojWnDbp eW {]ISamIpp.

_mlyeW Fmhcnepw D-mIWsan. c]cntim[\ \SptmgmImw CXdnbpI.

XmX vImenI hrkvXw`\w Fs\ Is-n ncoIcnpp?

hrkvXw`\ntebvv \bnmhp tcmKfntesXnepwDs-n chpw aq{Xhpw ]cntim[n v Hcp hrtcmK hnZKvZs\ImWWw. tcmKnbpsS AkpJns ImcWfpw ap ]cntim[\IfpsS dntmpIfpw ImWp Hcp hnZKvZ\v hrkvXw`\wDt-m Ctbm Fv Ddnp ]dbm km[npw.

NnIn

]qambpw NnInnv t`Zamm km[np Hcp tcmKamWv.

1 . {int- Imcy

hr kvXw`\ns ImcWs Is-n NnInnpI. acppw amhiyamb kwhn[m\fpw D]tbmKsSppI. `W \nb{Ww. Ubmennkv.

hrbpsS {]h\w XmXvImenIambn \nebvptm AXnsImcWw Is-nbm am{Xsa icnbmb NnIn \Im

XmXvImenI hrkvXw`\w 35.

]e ImcW sIm-pw XmXvImenIhr kvXw`\w kw`hnmw

XmXvImenI hrkvXw`\w ]qambpw NnInnvt`Zamm km[np Hcp tcmKamWv.

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Aymbw 9XmXvImenI hrkvXw`\wFmWv XmXvImenI hr kvXw`\w?

]e ImcW sIm-pw CXv kw`hnmw. {][m\ ImcWHp {inmw. hrbntebvp ctbmw IpdbpI. AXnkmcw, On,

s]m, cw hmp t]mhpI, ckw XmgpICsXmw sIm-v Pemwiw icocn \nv \jvSsSpIbpwctbmw IpdbpIbpw sNmw.

ISp AWp_m[, amcIamb tcmKw Asn Hcpikv{X{Inbbvptijhpw hrbpsS {]h\w s]spIpdbmw.

aq{XXSw: km[mcW hrpIfmWv CXn\v {][m\XSw.

Fen\n, kZi\w, AanX c{kmhw, sUn\n,KpcpXcamb lrt{ZmKw sk]vknkv (KpcpXcamb AWp_m[),cmkhkvXpfSnb Nne \mpacppI, thZ\kwlmcnI, knhmX NnInbpsS acppI, acppItfmSpAePn.

eWs]sp-mIp hrkvXw`\ns eWfpw As\Xsbmhmw. AXn\m AXv s]sp Xs {ibnsSpp.

aq{Xns Afhv KWyambn IpdbpI. IWmense \ocv,`mcw IqSpI.

hninmbva, On, Xf, oWw, kpt_m[w IpdbpI. izmkw ap, s\pthZ\, tNmc OnpI, lrZbanSnns

Xmfw sXpI, Pn, At_m[mh XpSnb Poh\p`ojWnDbp eW {]ISamIpp.

_mlyeW Fmhcnepw D-mIWsan. c]cntim[\ \SptmgmImw CXdnbpI.

XmX vImenI hrkvXw`\w Fs\ Is-n ncoIcnpp?

hrkvXw`\ntebvv \bnmhp tcmKfntesXnepwDs-n chpw aq{Xhpw ]cntim[n v Hcp hrtcmK hnZKvZs\ImWWw. tcmKnbpsS AkpJns ImcWfpw ap ]cntim[\IfpsS dntmpIfpw ImWp Hcp hnZKvZ\v hrkvXw`\wDt-m Ctbm Fv Ddnp ]dbm km[npw.

NnIn

]qambpw NnInnv t`Zamm km[np Hcp tcmKamWv.

1 . {int- Imcy

hr kvXw`\ns ImcWs Is-n NnInnpI. acppw amhiyamb kwhn[m\fpw D]tbmKsSppI. `W \nb{Ww. Ubmennkv.

hrbpsS {]h\w XmXvImenIambn \nebvptm AXnsImcWw Is-nbm am{Xsa icnbmb NnIn \Im

XmXvImenI hrkvXw`\w 35.

]e ImcW sIm-pw XmXvImenIhr kvXw`\w kw`hnmw

XmXvImenI hrkvXw`\w ]qambpw NnInnvt`Zamm km[np Hcp tcmKamWv.

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km[npIbpp. hrIv, aq{Xmib AWp_m[, ckwIpdb, CsXmw {]tXyIambn NnInnt-XmWv. Csnhr ho-pw kvXw`\mhbntebvv t]mImw. ImcWs NnInnptm B XS Asn AkpJ BhnmsX CcnpIbpw hr ]qambpw tcmK hnapamIpIbpwsNpw.

2 . NnInm coXnI

CXv sIm-v DtinpXv hrbvv Hcp XmmhpI FXmWv. AWp_m[bvp acpp \IpI. AePnbvp Imc

WtlXphpw hrbvp DXImXpamb acppI HgnhmpI.

aq{Xw D-mIphm\pw km{X Iqm\pw icocnse \ocpIpdv izmkw ap amphm\pw klmbnpI.

ktmnhv sXdmn: Ipd ckw, Hmm\w, On,s]mmknbs \nb{npI, izmkw ap, Pn ChbvvFmw Xs acpneqsS \nb{WnempI.

3. `W{Iaw

hrbpsS {]h\w \nb{W hnt[bambn \npXn`Ww {][m\ ]p hlnpp.

shw IrXyamb Afhn am{Xw D]tbmKnpI. Fpw F{Xshw IpSnmw, AXn F{X ]pdtbvp t]mIppCsXmw {]tXyIw \nconWw. shns D]tbmKwIpdm \ocv, izmkwap Ch XSbm km[npw.

]gh, DWnb ]gh, {^qv Pyqkv Chbnsemw [mcmfw s]mmknbw ASnbncnpp. hrbpsS{]h\w XmXvmenIambn \nebvptm cns]mmknbns Afhv IqSpp. CXv hrbvpw BpwXs Poh\p `ojWn Dbp HmWv. AXn\m ]gh HgnhmWw.

Dv \nb{npI; Dv \nb{nptm Zmlw Xms\Ipdbpp. \ocv, ckw izmkap CXns\mw Dns\nb{Ww Hcp ]cn[n hsc ]cnlmcw ImWpp.

4. Ubmennkv

hrbpsS {]h\w icocn\p shfnbn Ir{Xnaambn\SpXn\v Ubmennkv Fp ]dbpp. acWs hrtcmKnapJmapJw ImWptm Poh cnm Cv \nehnepXpwGhpw {]Nmcnepap NnInXvkmcoXnbmWnXv.

Ubmennkv c-p Xcnep-v.

lotamUbmennkv: Bip]{Xnbn sNpXv; s]cntmWnbUbmennkv: hon sNpXv.

FtmgmWv XmXvImenI hrkvXw`\n Ubmennkv BhiywhcpXv? tcmKeW acppsIm-p am{Xw amdmsXhcnIbpw tcmKeW aqnpIbpw sNbvXm Ubmennkv sNbvXv icocns kpenXmhsb XncnsI sIm-phcpp.

36. hrIsf kwcnpI XmXvImenI hrkvXw`\w 37.

hrbpsS {]h\w \nb{Whnt[bambn\npXn `W{Iaw {][m\ ]p hlnpp

hrbpsS {]h\w icocn\p shfnbnIr{Xnaambn \SpXn\v Ubmennkv Fp ]dbpp

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km[npIbpp. hrIv, aq{Xmib AWp_m[, ckwIpdb, CsXmw {]tXyIambn NnInnt-XmWv. Csnhr ho-pw kvXw`\mhbntebvv t]mImw. ImcWs NnInnptm B XS Asn AkpJ BhnmsX CcnpIbpw hr ]qambpw tcmK hnapamIpIbpwsNpw.

2 . NnInm coXnI

CXv sIm-v DtinpXv hrbvv Hcp XmmhpI FXmWv. AWp_m[bvp acpp \IpI. AePnbvp Imc

WtlXphpw hrbvp DXImXpamb acppI HgnhmpI.

aq{Xw D-mIphm\pw km{X Iqm\pw icocnse \ocpIpdv izmkw ap amphm\pw klmbnpI.

ktmnhv sXdmn: Ipd ckw, Hmm\w, On,s]mmknbs \nb{npI, izmkw ap, Pn ChbvvFmw Xs acpneqsS \nb{WnempI.

3. `W{Iaw

hrbpsS {]h\w \nb{W hnt[bambn \npXn`Ww {][m\ ]p hlnpp.

shw IrXyamb Afhn am{Xw D]tbmKnpI. Fpw F{Xshw IpSnmw, AXn F{X ]pdtbvp t]mIppCsXmw {]tXyIw \nconWw. shns D]tbmKwIpdm \ocv, izmkwap Ch XSbm km[npw.

]gh, DWnb ]gh, {^qv Pyqkv Chbnsemw [mcmfw s]mmknbw ASnbncnpp. hrbpsS{]h\w XmXvmenIambn \nebvptm cns]mmknbns Afhv IqSpp. CXv hrbvpw BpwXs Poh\p `ojWn Dbp HmWv. AXn\m ]gh HgnhmWw.

Dv \nb{npI; Dv \nb{nptm Zmlw Xms\Ipdbpp. \ocv, ckw izmkap CXns\mw Dns\nb{Ww Hcp ]cn[n hsc ]cnlmcw ImWpp.

4. Ubmennkv

hrbpsS {]h\w icocn\p shfnbn Ir{Xnaambn\SpXn\v Ubmennkv Fp ]dbpp. acWs hrtcmKnapJmapJw ImWptm Poh cnm Cv \nehnepXpwGhpw {]Nmcnepap NnInXvkmcoXnbmWnXv.

Ubmennkv c-p Xcnep-v.

lotamUbmennkv: Bip]{Xnbn sNpXv; s]cntmWnbUbmennkv: hon sNpXv.

FtmgmWv XmXvImenI hrkvXw`\n Ubmennkv BhiywhcpXv? tcmKeW acppsIm-p am{Xw amdmsXhcnIbpw tcmKeW aqnpIbpw sNbvXm Ubmennkv sNbvXv icocns kpenXmhsb XncnsI sIm-phcpp.

36. hrIsf kwcnpI XmXvImenI hrkvXw`\w 37.

hrbpsS {]h\w \nb{Whnt[bambn\npXn `W{Iaw {][m\ ]p hlnpp

hrbpsS {]h\w icocn\p shfnbnIr{Xnaambn \SpXn\v Ubmennkv Fp ]dbpp

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F{XImew Cu Ahbn Ubmennkv Bhiyambnhcpp?

hrbpsS {]h\w ]qnXnbnemIpXphsc UbmennkvBhiyw hcmw. km[mcW 14 BgvNbvpn tcmKn ]gb BtcmKy \nebntebvv Xncnp hcpw. B kabv Ubmennkv \nm km[npw.

Hcn Ubmennkv sNbvXm AXp \nm km[nn FXv sXmb [mcWbmWv. XmXvmenI kvXw`\n HcnepwUbmennkv PohnXImew apgph XpStc- H. Poh\p`ojWn IWmnbmWv UbmenneqsS hrsbbpw icoctbpw kwcnpXv.

Fs\ XmXvImenI hr kvXw`\w XSbmw?

kvXw`\w D-mmhp ImcW D-mbm hr hnZKvZs\tbmHcp ^nknjys\tbm kao]npI.

ckw Xmtgp t]mbm DS\Sn AXn\mhiyambXv sNpI.

A\mhiyambn thZ\ kwlmcnI ap acppI HpwtUmIvSdpsS \nti {]ImcamsX D]tbmKncpXv. AWp_m[,aq{Xns Afhv IpdbpI Chbp-mbm DS\Sn sshZyklmbwtXSpI.

38. hrIsf kwcnpI

Aymbw 10amcIamb hrtcmKImcW

sshZyimkv{X n CXphsc ]q tcmK hnapn AhImisSphm Ignbm Hcp AkpJamWv mbnbmb hrkvXw`\w. CXv hfsc thKn \psS kaqln hnphcpHcp nXnhntijamWv CpXv. ]nsemcmv hrtcmKaps-v IWpI hyampp.

mbnbmb hrkvXw`\w kw`hnm cnse {Inbmns(Creatinine) Afhv IqSpw. am{Xa kvIm\n hr NpcpnbXmbnImWsSpw.

mbnbmb hrkvXw`\w F ]Zw Aw `bapfhmpXmWv. hrkvXw`\ns BZyLn hrbpsS {]h\wIpdp Fp am{Xsa Aapp. AXv ]qambpw{]h\ clnXambn Fan.

FUv tPv InUv\n s^bnenb = mbnbmb hrkvXw`\ns Amw LamWnXv. hr ]qambpw Cu Ln\nebvpp. acppw ` W\nb{Whpw sIm-v am{Xw Imcyan.adnv Ubmenntkm hramnhbvtem \St-nhcpw.

FpsIm-v hr ]qambpw kvXw`npp?1. {]talw: 3540% hsc hrtcmK I-phcpX

{]tal tcmKnIfnemWv.2. Db ckw: 30% hrtcmKfpsS ImcWmc

Db ckamWv.

hrbpsS {]h\w ]qnXnbnemIpXphscUbmennkv Bhiyw hcmw.

]nsemcmv hrtcmKap-v

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F{XImew Cu Ahbn Ubmennkv Bhiyambnhcpp?

hrbpsS {]h\w ]qnXnbnemIpXphsc UbmennkvBhiyw hcmw. km[mcW 14 BgvNbvpn tcmKn ]gb BtcmKy \nebntebvv Xncnp hcpw. B kabv Ubmennkv \nm km[npw.

Hcn Ubmennkv sNbvXm AXp \nm km[nn FXv sXmb [mcWbmWv. XmXvmenI kvXw`\n HcnepwUbmennkv PohnXImew apgph XpStc- H. Poh\p`ojWn IWmnbmWv UbmenneqsS hrsbbpw icoctbpw kwcnpXv.

Fs\ XmXvImenI hr kvXw`\w XSbmw?

kvXw`\w D-mmhp ImcW D-mbm hr hnZKvZs\tbmHcp ^nknjys\tbm kao]npI.

ckw Xmtgp t]mbm DS\Sn AXn\mhiyambXv sNpI.

A\mhiyambn thZ\ kwlmcnI ap acppI HpwtUmIvSdpsS \nti {]ImcamsX D]tbmKncpXv. AWp_m[,aq{Xns Afhv IpdbpI Chbp-mbm DS\Sn sshZyklmbwtXSpI.

38. hrIsf kwcnpI

Aymbw 10amcIamb hrtcmKImcW

sshZyimkv{X n CXphsc ]q tcmK hnapn AhImisSphm Ignbm Hcp AkpJamWv mbnbmb hrkvXw`\w. CXv hfsc thKn \psS kaqln hnphcpHcp nXnhntijamWv CpXv. ]nsemcmv hrtcmKaps-v IWpI hyampp.

mbnbmb hrkvXw`\w kw`hnm cnse {Inbmns(Creatinine) Afhv IqSpw. am{Xa kvIm\n hr NpcpnbXmbnImWsSpw.

mbnbmb hrkvXw`\w F ]Zw Aw `bapfhmpXmWv. hrkvXw`\ns BZyLn hrbpsS {]h\wIpdp Fp am{Xsa Aapp. AXv ]qambpw{]h\ clnXambn Fan.

FUv tPv InUv\n s^bnenb = mbnbmb hrkvXw`\ns Amw LamWnXv. hr ]qambpw Cu Ln\nebvpp. acppw ` W\nb{Whpw sIm-v am{Xw Imcyan.adnv Ubmenntkm hramnhbvtem \St-nhcpw.

FpsIm-v hr ]qambpw kvXw`npp?1. {]talw: 3540% hsc hrtcmK I-phcpX

{]tal tcmKnIfnemWv.2. Db ckw: 30% hrtcmKfpsS ImcWmc

Db ckamWv.

hrbpsS {]h\w ]qnXnbnemIpXphscUbmennkv Bhiyw hcmw.

]nsemcmv hrtcmKap-v

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40. hrIsf kwcnpI

Aymbw 11

amcIamb hrtcmK eWfpw NnInbpw

mbnbmb hr kvXw`\w: eW/Is-epI.

mbnbmb hrkvXw`\n hrI BgvNItfm, amktfm,hjtfm sIm-v ]Xps]Xps {]h\clnXamIpp.AXn\m icocw GsdIpsd CXnt\mSv s]mcpsSpp.hrbvv AXns {]h\n A]ImXIfp-mbmepw AXv_mlyambn {]ISnnmsX Ccnm\pff Ignhp-v. AXn\m antcmKnIfnepw Hcnepw Hcp eWhpw {]ISamImdn. {]ISambeW I-pXpSptmtgbvpw hr ]qambpwXIcmdnembnp-mhpw.

hrtcmKns hym]vXn Hmtcm hynbnepw hyXykvXambncnpw.Nnecn _mlyamb Hcp eWhpansn IqSn hr ]qkvXw`\mhbnembncnpw. AXn\m sSpI, _mlyamb]cntim[\I CsXmw ASnm\ sSpnbmbncnpwtcmKns Xo{hXbpw NnInbpw XncsSppI.

mbnbmb hrkvXw`\ns eW:hrbpsS kvXw`\mhbpsS Xo{hX Is-n AXnsASnm\nemhpw NnIn \nbnpI. kvXw`\mhF{Xtmfw D-v Fv Adnbphm (GFR) tmadpem ^nt{Sj tcv sSv \Spp. sSns ASnm\n hrbpsS kvXw`\mhsb 5 Bbn XcwXncnmw. GFR s Afhv

3. tmadptms\s{^nkv: amcIamb hr tcmKfptSbpwkvXw`\ntbpw ImcWn {]talw ckwIgnm ]ns hn.

4. t]mfnknnIv hrtcmKw: ]mccyambn I-phcp CuhrtcmKn c-p hrbnepw Hne[nIw apgID-mIpw.

5. ap ImcW: hrbpsS {]mbw, hrbntebvpcpg NpcppI, aq{XXSw - hrpI sImt-mt{]mkvtS v {KnbpsS henqSpX sImt-m,acppIfpsS sXmb D]tbmKw.

an tcmKnIfnepw Hcnepw HcpeWhpw {]ISamImdn

t]mfnknnIv hrtcmKw ]mccyambn I-phcpp

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40. hrIsf kwcnpI

Aymbw 11

amcIamb hrtcmK eWfpw NnInbpw

mbnbmb hr kvXw`\w: eW/Is-epI.

mbnbmb hrkvXw`\n hrI BgvNItfm, amktfm,hjtfm sIm-v ]Xps]Xps {]h\clnXamIpp.AXn\m icocw GsdIpsd CXnt\mSv s]mcpsSpp.hrbvv AXns {]h\n A]ImXIfp-mbmepw AXv_mlyambn {]ISnnmsX Ccnm\pff Ignhp-v. AXn\m antcmKnIfnepw Hcnepw Hcp eWhpw {]ISamImdn. {]ISambeW I-pXpSptmtgbvpw hr ]qambpwXIcmdnembnp-mhpw.

hrtcmKns hym]vXn Hmtcm hynbnepw hyXykvXambncnpw.Nnecn _mlyamb Hcp eWhpansn IqSn hr ]qkvXw`\mhbnembncnpw. AXn\m sSpI, _mlyamb]cntim[\I CsXmw ASnm\ sSpnbmbncnpwtcmKns Xo{hXbpw NnInbpw XncsSppI.

mbnbmb hrkvXw`\ns eW:hrbpsS kvXw`\mhbpsS Xo{hX Is-n AXnsASnm\nemhpw NnIn \nbnpI. kvXw`\mhF{Xtmfw D-v Fv Adnbphm (GFR) tmadpem ^nt{Sj tcv sSv \Spp. sSns ASnm\n hrbpsS kvXw`\mhsb 5 Bbn XcwXncnmw. GFR s Afhv

3. tmadptms\s{^nkv: amcIamb hr tcmKfptSbpwkvXw`\ntbpw ImcWn {]talw ckwIgnm ]ns hn.

4. t]mfnknnIv hrtcmKw: ]mccyambn I-phcp CuhrtcmKn c-p hrbnepw Hne[nIw apgID-mIpw.

5. ap ImcW: hrbpsS {]mbw, hrbntebvpcpg NpcppI, aq{XXSw - hrpI sImt-mt{]mkvtS v {KnbpsS henqSpX sImt-m,acppIfpsS sXmb D]tbmKw.

an tcmKnIfnepw Hcnepw HcpeWhpw {]ISamImdn

t]mfnknnIv hrtcmKw ]mccyambn I-phcpp

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hrbpsS {]h\ aXsb Is-p Hcp sSmWv. GFRs t\ma hmeyp (Normal Value) 90ml/min. hr amen\ywAcnp tXmXmWv GFR kqNnnpXv.

Stage 1 GFR >90 m/min

Stage 2 60-89 ml/min

Stage 3 30-59 ml/min

Stage 4 15-29 ml/min

Stage 5

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hrbpsS {]h\ aXsb Is-p Hcp sSmWv. GFRs t\ma hmeyp (Normal Value) 90ml/min. hr amen\ywAcnp tXmXmWv GFR kqNnnpXv.

Stage 1 GFR >90 m/min

Stage 2 60-89 ml/min

Stage 3 30-59 ml/min

Stage 4 15-29 ml/min

Stage 5

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AanX ckap Hcmfn FtmgmWv CKD AYhmmbnbmb hrkvXw`\w kwibnt-Xv? AanX ckw D-mIpXp 30 hbn\p aptm 50

hbn\p tijtam BsWn. ckw Is-p kabv 200/120 BsWn. acpp]tbmKnnpw \nb{Wm[o\amIm ckw. ImgvNpdhv ckw aqew. aq{Xn t{]mo\ns Awiw. hninmbva, \ocv, oWw.

mb nb mb h r k vX w `\ns AnaL n Fsmw kw`hnmw? izmkwap, izmkXSw, s\pthZ\, icocnse \ocv,

izmktIminse \ocv (Pulmonary edema) AanX hw. AanXamb Hmm\w, On. AXn`bc oWw. akvXnjvIns {]h\s _m[npI, AanXamb

Ddw, Pn, t_m[w adbpI. s]mmknbw cn AanXambn ImWpI. CXv

lrZbns {]h\s \nebvm ImcWamtbpw. lrZbs BKncWw sNp sXmenbn \ocv .hrtcmKw Fs\ ncoIcnpw? lotamtm_n: c ]cntim[\bn lotamtm_n

Ipdhmbn I-m.

aq{X]cntim[\: aq{Xn t{]mo\ns Awiw Is-pI.sNdnb tXmXnsenepw B_pans kmnyw aq{Xnep-mIpI.AanXambn hymbmaw sNbvXmepw ]\n hmepw t{]moB_pan Is-nbm IqSpX ]cntim[\ \SnhrtcmKw XsbmtWm Fpdp hcpWw.

skdw {Inbmn\n, bqdnb ss\{SP & CPnF^B (Serumcreatinine, blood urea nitrogen & eGFR).

Ghpw efnXhpw Cv {]NmcnepXpamb Hcp sSmWvc]cntim[\. c ]cntim[\bneqsS {Inbmn\nsbpwbqdnbptSbpw Afhv IqSnbm Adnbm km[npw. am{Xambnbmb hrkvXw`\ns NnInm kabv tcmKmhbn D-mIp amsfpdndnbm Ghpw ^ e{]ZambsSp IqSnbmWnXv. eGFR sSv hfsc t\cs Xs hrbpsS A]cym]vXXsbpdn v kqN\ e`nm sNp Hcp sSmWv. eGFR ASnm\n hr tcmKs Ap LfmbnXcwXncnmw. tcmKs IpdpIqSn Adnbphm\pw IqSpX^e{]Zambn NnInnm\pw CXv klmbIamIpw.

hrbpsS kvIm (Ultrasound Scan)hr Nn{Xw e`npXneqsS hrbpsS henspdnv Hcp[mcW hrtcmK hnZKv[\p e`npp. Npcpnb hrmbnbmb hrtcmKs kqNnnpp.

ap ]cntim[\I

hrkvXw`\w tcmKnbn ap tcmK{]iv\fpw krjvSnpp.AXv IrXyambn Adnbm Hcp tUmIvS ap sSpI

44. hrIsf kwcnpI amcIamb hrtcmK eWfpw NnInbpw 45.

s]mmknbw cn AanXambm lrZbns{]h\s \nebvm ImcWamtbpw

Npcpnb hr mbnbmbhrtcmKs kqNnnpp

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AanX ckap Hcmfn FtmgmWv CKD AYhmmbnbmb hrkvXw`\w kwibnt-Xv? AanX ckw D-mIpXp 30 hbn\p aptm 50

hbn\p tijtam BsWn. ckw Is-p kabv 200/120 BsWn. acpp]tbmKnnpw \nb{Wm[o\amIm ckw. ImgvNpdhv ckw aqew. aq{Xn t{]mo\ns Awiw. hninmbva, \ocv, oWw.

mb nb mb h r k vX w `\ns AnaL n Fsmw kw`hnmw? izmkwap, izmkXSw, s\pthZ\, icocnse \ocv,

izmktIminse \ocv (Pulmonary edema) AanX hw. AanXamb Hmm\w, On. AXn`bc oWw. akvXnjvIns {]h\s _m[npI, AanXamb

Ddw, Pn, t_m[w adbpI. s]mmknbw cn AanXambn ImWpI. CXv

lrZbns {]h\s \nebvm ImcWamtbpw. lrZbs BKncWw sNp sXmenbn \ocv .hrtcmKw Fs\ ncoIcnpw? lotamtm_n: c ]cntim[\bn lotamtm_n

Ipdhmbn I-m.

aq{X]cntim[\: aq{Xn t{]mo\ns Awiw Is-pI.sNdnb tXmXnsenepw B_pans kmnyw aq{Xnep-mIpI.AanXambn hymbmaw sNbvXmepw ]\n hmepw t{]moB_pan Is-nbm IqSpX ]cntim[\ \SnhrtcmKw XsbmtWm Fpdp hcpWw.

skdw {Inbmn\n, bqdnb ss\{SP & CPnF^B (Serumcreatinine, blood urea nitrogen & eGFR).

Ghpw efnXhpw Cv {]NmcnepXpamb Hcp sSmWvc]cntim[\. c ]cntim[\bneqsS {Inbmn\nsbpwbqdnbptSbpw Afhv IqSnbm Adnbm km[npw. am{Xambnbmb hrkvXw`\ns NnInm kabv tcmKmhbn D-mIp amsfpdndnbm Ghpw ^ e{]ZambsSp IqSnbmWnXv. eGFR sSv hfsc t\cs Xs hrbpsS A]cym]vXXsbpdn v kqN\ e`nm sNp Hcp sSmWv. eGFR ASnm\n hr tcmKs Ap LfmbnXcwXncnmw. tcmKs IpdpIqSn Adnbphm\pw IqSpX^e{]Zambn NnInnm\pw CXv klmbIamIpw.

hrbpsS kvIm (Ultrasound Scan)hr Nn{Xw e`npXneqsS hrbpsS henspdnv Hcp[mcW hrtcmK hnZKv[\p e`npp. Npcpnb hrmbnbmb hrtcmKs kqNnnpp.

ap ]cntim[\I

hrkvXw`\w tcmKnbn ap tcmK{]iv\fpw krjvSnpp.AXv IrXyambn Adnbm Hcp tUmIvS ap sSpI

44. hrIsf kwcnpI amcIamb hrtcmK eWfpw NnInbpw 45.

s]mmknbw cn AanXambm lrZbns{]h\s \nebvm ImcWamtbpw

Npcpnb hr mbnbmbhrtcmKs kqNnnpp

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\ntinpp. (DZm. Imknbw, t^mkv^dkv, qtmkv,C.kn.Pn. BZnbmbh).

FtmgmWv tUmIvSsd kao]nt-Xv? aq{Xw IpdXmbn tXmptm \oc v IqSnbXmbn

tXmnbm s]sv `mcw IqSnbm izmkw apA\p`hsm {]tXyInv InSptm.

s\pthZ\, s\nSnv IqSpI, ]\n, hbdnfw,hninmbva, On, Onptm cabw ImWpI.

tImnnSpw Asn t]inIv _epdhv. Ddw Xq, Pn, Hmpdhv. \nb{Wambncp ckw s]sv IqSpI. Nph aq{Xw Asn AanX c{kmhw.

46. hrIsf kwcnpI

Aymbw 12hrtcmKhpw NnInbpw

aqv Xcw coXnbnemWv hr tcmKns NnIn1. acpv 2. `W \nb{Ww, 3. IqsS IqsS ]cntim[\

CsXmw BZyLn sNsSpp. {Inbmn\n hfscIqSpX Dhpam{Xsa XpSn Ubmenn\v sNppp. tcmKw aqnv ap Ahbhv IqSn tISp]mSp kw`hnmXncnm\mWv CXv sNpXv. aphv tcmKns ImTn\ywA\pkcnv NnIn hn[npp.

acpv `Ww Ch \nb{nnpw hrbpsS {]h\whjfmbm Ubmennkv \ntinsSpp.

hr amnhbv asmcp {]Xnhn[nbmbn IWmmw.Fm CXv BfpsS {]mbw, BtcmKy\ne Chsb FmwB{ibnncnpw.

hr kvXw`\ns BZyLn sshZyimkv{Xns]v FmWv?hrtcmKw _m[n Hcm hrkvXw`\w D-mIptmgmWv]qambn hrtcmKn Fp hntijnnsSpXv. hrkvXw`\n\v (CKD) NnIn Cv 5-10% tcmKnIv am{Xsae`nppp. `mcn NnInm Nnehp ImcWw ]e tcmKnIfpwNnIn InmsX acnp Hch D-mIpp. CsXmgnhmpXneqsS At\Iw tcmKnIv tcmKw aqnp Hch Hgnhmmw. app kqNnn sSpI hfsc Nnehp IpdhbmWv {]tXyInv chpw aq{Xhpw ]cntim[\I. hj

{Inbmn\n hfsc IqSpXDhp Ubmennkv sNpw

hrkvXw`\w tcmKnbn aptcmK{]iv\fpw krjvSnpp

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\ntinpp. (DZm. Imknbw, t^mkv^dkv, qtmkv,C.kn.Pn. BZnbmbh).

FtmgmWv tUmIvSsd kao]nt-Xv? aq{Xw IpdXmbn tXmptm \oc v IqSnbXmbn

tXmnbm s]sv `mcw IqSnbm izmkw apA\p`hsm {]tXyInv InSptm.

s\pthZ\, s\nSnv IqSpI, ]\n, hbdnfw,hninmbva, On, Onptm cabw ImWpI.

tImnnSpw Asn t]inIv _epdhv. Ddw Xq, Pn, Hmpdhv. \nb{Wambncp ckw s]sv IqSpI. Nph aq{Xw Asn AanX c{kmhw.

46. hrIsf kwcnpI

Aymbw 12hrtcmKhpw NnInbpw

aqv Xcw coXnbnemWv hr tcmKns NnIn1. acpv 2. `W \nb{Ww, 3. IqsS IqsS ]cntim[\

CsXmw BZyLn sNsSpp. {Inbmn\n hfscIqSpX Dhpam{Xsa XpSn Ubmenn\v sNppp. tcmKw aqnv ap Ahbhv IqSn tISp]mSp kw`hnmXncnm\mWv CXv sNpXv. aphv tcmKns ImTn\ywA\pkcnv NnIn hn[npp.

acpv `Ww Ch \nb{nnpw hrbpsS {]h\whjfmbm Ubmennkv \ntinsSpp.

hr amnhbv asmcp {]Xnhn[nbmbn IWmmw.Fm CXv BfpsS {]mbw, BtcmKy\ne Chsb FmwB{ibnncnpw.

hr kvXw`\ns BZyLn sshZyimkv{Xns]v FmWv?hrtcmKw _m[n Hcm hrkvXw`\w D-mIptmgmWv]qambn hrtcmKn Fp hntijnnsSpXv. hrkvXw`\n\v (CKD) NnIn Cv 5-10% tcmKnIv am{Xsae`nppp. `mcn NnInm Nnehp ImcWw ]e tcmKnIfpwNnIn InmsX acnp Hch D-mIpp. CsXmgnhmpXneqsS At\Iw tcmKnIv tcmKw aqnp Hch Hgnhmmw. app kqNnn sSpI hfsc Nnehp IpdhbmWv {]tXyInv chpw aq{Xhpw ]cntim[\I. hj

{Inbmn\n hfsc IqSpXDhp Ubmennkv sNpw

hrkvXw`\w tcmKnbn aptcmK{]iv\fpw krjvSnpp

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nsemcn CXv sNp Hcmv tcmKeW HpwCsn IqSn hrbvv XIcm Ds-n Xncndnbmkm[nw. am{Xa ckw hrtcmKns hn\mbncnssNdpm DsSbph \nbambpw CXv ]cntim[n v th-NnIn kzoIcnWw.

sshZyimkv{Xw tcmKmh hsc tcmKnsb FnmsX AXn\vth- apIcpXepI kzoIcnm kaqls t_m[hXvIcnpp. BZyLnse NnIn hfsc KpWw sNpw. tcmKwaqnpw tXmdpw tcmKnbpsS acpnt\mSp {]XnIcWtijnIpdbpp. ]etmgpw hrtcmKns imcocnIhpw,. am\nIhpw kmnIhpamb LSI a\nemmsX acppw`W \nb{Whpw tcmKnI \npp. CXv D tcmKsIpdbvpIb adnv IqpIbs{X sNpXv.Ubmennkv hr amnhbv Cu Ahhsc tcmKnFmXncnm {]tXyIw {inWw.saUn amt\Pvsav F ]Zw sIm-v DtinpX vFv?

tcmKmh KpcpXcamImsX tcmKs \nb{WnempIFmWv CXv sI-ptinpXv.

tcmKns ]ptcmKXnsb Ipdbvpp. tcmKImcWs NnInnpp. _mly eWsf Ipdbvm th-Xv sNpp. lrt{ZmKs sNdpm {ianpp. Ubmennttbm hramnhbventtbm BhiyIX

XmXvImenIambnsnepw \om {ianpp.

hrtcmKn PohnX ssienbn hcpt- am

]pIhen \npI.

`mcw \nb{npI, FtmgpwimcocnIambn hymbmawe`np FsnepwsNpI.

aZy]m\w HgnhmpI.

Dns D]tbmKw IpdbvpI

kaoIrXamb BlmcwIgnpI.

Hcp hrtcmK hnZKvZs\ImWpI.

hrtcmKns ImTn\yw A\pkcnv Hmtcm Bpw `W\nb{Ww hyXymkamImw.

Dv: Dns Afhv IpdbvpXv hgn ckw, \ocvCsXmw Ipdbpp.

Dns AanXamb D]tbmKw FptinpXv FmsWvt\mmw.

taibn `Wn ho-pw Dv tNp Hcp coXn CvhoSpIfn ImWmdp-v. CXv HgnhmpI.

^mv ^ pUv, ]Sw, Am, Sn^pUpI, Ch HgnhmpI. shns Afhv : aq{Xw Ipdbptm \ocv, izmkw ap

Ch tcmKnbvv A\p`hsSpp. AXn\m Fm hrtcmKnIfpw shw/Pew \nb{nm BhiysSpp.

hrIsfkwcnphm\p

{][m\ NnIn

ckw

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nsemcn CXv sNp Hcmv tcmKeW HpwCsn IqSn hrbvv XIcm Ds-n Xncndnbmkm[nw. am{Xa ckw hrtcmKns hn\mbncnssNdpm DsSbph \nbambpw CXv ]cntim[n v th-NnIn kzoIcnWw.

sshZyimkv{Xw tcmKmh hsc tcmKnsb FnmsX AXn\vth- apIcpXepI kzoIcnm kaqls t_m[hXvIcnpp. BZyLnse NnIn hfsc KpWw sNpw. tcmKwaqnpw tXmdpw tcmKnbpsS acpnt\mSp {]XnIcWtijnIpdbpp. ]etmgpw hrtcmKns imcocnIhpw,. am\nIhpw kmnIhpamb LSI a\nemmsX acppw`W \nb{Whpw tcmKnI \npp. CXv D tcmKsIpdbvpIb adnv IqpIbs{X sNpXv.Ubmennkv hr amnhbv Cu Ahhsc tcmKnFmXncnm {]tXyIw {inWw.saUn amt\Pvsav F ]Zw sIm-v DtinpX vFv?

tcmKmh KpcpXcamImsX tcmKs \nb{WnempIFmWv CXv sI-ptinpXv.

tcmKns ]ptcmKXnsb Ipdbvpp. tcmKImcWs NnInnpp. _mly eWsf Ipdbvm th-Xv sNpp. lrt{ZmKs sNdpm {ianpp. Ubmennttbm hramnhbventtbm BhiyIX

XmXvImenIambnsnepw \om {ianpp.

hrtcmKn PohnX ssienbn hcpt- am

]pIhen \npI.

`mcw \nb{npI, FtmgpwimcocnIambn hymbmawe`np FsnepwsNpI.

aZy]m\w HgnhmpI.

Dns D]tbmKw IpdbvpI

kaoIrXamb BlmcwIgnpI.

Hcp hrtcmK hnZKvZs\ImWpI.

hrtcmKns ImTn\yw A\pkcnv Hmtcm Bpw `W\nb{Ww hyXymkamImw.

Dv: Dns Afhv IpdbvpXv hgn ckw, \ocvCsXmw Ipdbpp.

Dns AanXamb D]tbmKw FptinpXv FmsWvt\mmw.

taibn `Wn ho-pw Dv tNp Hcp coXn CvhoSpIfn ImWmdp-v. CXv HgnhmpI.

^mv ^ pUv, ]Sw, Am, Sn^pUpI, Ch HgnhmpI. shns Afhv : aq{Xw Ipdbptm \ocv, izmkw ap

Ch tcmKnbvv A\p`hsSpp. AXn\m Fm hrtcmKnIfpw shw/Pew \nb{nm BhiysSpp.

hrIsfkwcnphm\p

{][m\ NnIn

ckw

s]mmknbw: Fm ^efnepw s]mmknbw ASnbncnpp. tX, DW]gh, Ingv, Hmdv, ]gw,sSmamtm; s]mmknbw IqSpX lrZbns {]h\wXIcmdnemIpp. AXp XSbm\mWv s]mmknbw Ie`Ww \nb{npXv.

AanXamb t{]mo HgnhmpI. CXv hrbpsS {]h\s {]XnIqeambn _m[nmw.

mbnbmb hr kvXw`\ntebvp \bnmsX HcmvXs hrIsf Fs\ kwcnmw? AXn\p th-apIcpXepI cks \nb{npI. hrIsf am{Xa Xe

tmdns\bpw, lrZbns\bpw XIcmdnempw. ckw 130/80 Xmsg \ne\nm {inpI. c

kw IqSpw tXmdpw hrbntep cIpgepIvXw kw`hnm km[yX IqSpXemWv.

tUmIvSsd kao]nv ckw ]cntim[nnpI. acpv\ntim\pkcWw D]tbmKnpI.

{]taltcmKnIfn `Ww \nb{nm {]tXyIw{inWw. tUmIvSsd I-p ncambn acpv Bhiysan IgnWw.

hjnsemcn chpw aq{Xhpw ]cntim[n v tUmIvSsdkao]npI.

_mlyeW I-m \nmcambn XnfbcpXv. t\cs Adnm NnInnv \nb{Whnt[bammsav

XncndnbpI. aq{Xv, AWp_m[, aq{XXSw CXns\mw kzbw

NnInnmsX tUmIvSdpsS klmbw tXSpI.

50. hrIsf kwcnpI

cks \nb{npI

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s]mmknbw: Fm ^efnepw s]mmknbw ASnbncnpp. tX, DW]gh, Ingv, Hmdv, ]gw,sSmamtm; s]mmknbw IqSpX lrZbns {]h\wXIcmdnemIpp. AXp XSbm\mWv s]mmknbw Ie`Ww \nb{npXv.

AanXamb t{]mo HgnhmpI. CXv hrbpsS {]h\s {]XnIqeambn _m[nmw.

mbnbmb hr kvXw`\ntebvp \bnmsX HcmvXs hrIsf Fs\ kwcnmw? AXn\p th-apIcpXepI cks \nb{npI. hrIsf am{Xa Xe

tmdns\bpw, lrZbns\bpw XIcmdnempw. ckw 130/80 Xmsg \ne\nm {inpI. c

kw IqSpw tXmdpw hrbntep cIpgepIvXw kw`hnm km[yX IqSpXemWv.

tUmIvSsd kao]nv ckw ]cntim[nnpI. acpv\ntim\pkcWw D]tbmKnpI.

{]taltcmKnIfn `Ww \nb{nm {]tXyIw{inWw. tUmIvSsd I-p ncambn acpv Bhiysan IgnWw.

hjnsemcn chpw aq{Xhpw ]cntim[n v tUmIvSsdkao]npI.

_mlyeW I-m \nmcambn XnfbcpXv. t\cs Adnm NnInnv \nb{Whnt[bammsav

XncndnbpI. aq{Xv, AWp_m[, aq{XXSw CXns\mw kzbw

NnInnmsX tUmIvSdpsS klmbw tXSpI.

50. hrIsf kwcnpI

cks \nb{npI

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Aymbw 13Ubmennkv

FmWv Ubmenknkv

hrI {]h\clnXamb Ahbn icocnsBcnImhbhfn sInnSp amen\y \opIbpwshw, Dv XpSnb LSIfpsS Afhv \nb{npIbpwsNp Hcp Ir{Xna coXnbmWv Ubmenknkv.Ubmenknkns\ (1) lotamUbmenknkv (2) s]cntmWnbUbmenknkv Fns\ c-mbn Xcw Xncnncnpp.1. lotamUbmenknkv:

Ccw Ubmenknkn icocnse cw ]pdtbvsSpv{]tXyIw cq]Iev]\ sNbvX Hcp hebneqsS ISnhnSpp. Cuhebn ImWp At\Imbncw \mcpIfneqsS ISpt]mIpcn \nv amen\yfpw apw hensSp v icocn\v th-Nne LSI AtX cntev ISnhnSpp. As\icocw Hcp kpenXmhbn Fpp.2. s]cntmWnb Ubmenknkv

ap]d coXnbn \npw hyXykvXambn ChnsS hebpsS Iw\nlnpXv DZcnse Bcmhbhsf s]mXnncnp ""s]cntmWnbw'' F BhcWamWv. icocnsicnbmb {]h\n\mhiyamb LSIfpw aqeIfpwASnb Hcp {ZmhIw Cu s]cntmWnbn \nt]npp.s]cntmWnbnse cpgepIfn \nv amen\ytad {ZmhIntev hcpIbpw AXn ASnbnp

kqvaLSI cpgepIfntev t]mIpIbpw sNpp.Cu {ZmhIw Ipdv kabn\ptijw \ow sNpp. Cu coXnBhnsSpp.

`W {IaoIcWw Ubmenknkv sNp tcmKnIvthtWm?

thWw. {][m\ambpw Dv, s]mmkyw, t^mkv^dkv, shw, Ch\nb{nWw. Ubmenknkv XpSnbXn\ptijw t{]mo\nsAfhv IqWw.

Dry Weight Fm Fv?

icocnse A[nIap shw FSppIfXn\ptijap`mcamWv Dry Weight.

lotamUbmenknkv Fs\ sNpw?

anhmdpw Hcp Bip]{Xnbnse Ubmenknkv bqWnnemWvsNpXv. CXn\p tUmIvS, \gvkv, sSIv\ojy FnhcpsSklmbw thWw. Hmtcm an\nnepw 250 ann cw icocn \nvUbssekdntev ]v sNsSpp. cw I]nSnmXncnmacpp sImSppp.

1. Ubssek AYhm Bn^njy InUv\nbneqsSA[nIap Pehpw amen\yhpw icocn \nv ^nsNpp.

2. ipoIcn cw icocntev Xncnp hnSpp.3. BgvNbn aqp {]mhiyw lotamUbmenknkv sNWw. Hmtcm

{]mhiyhpw