Curs Dr. Ismail ND 2013

8/19/2019 Curs Dr. Ismail ND 2013

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• Gkhcdtul zhahrht (G_) dstd ` c`hlh ir`fkih ihrd hnditdhzh

kf prdzdft 9>> mklk`hfd gd `hmdfk kf kftrdhjh lumd (>.7%gkf p`pulhtkh hgulth) sk sd dstkmdhzh ih vh houfjd shhnditdzd kf hful 3595 pdstd !55 mklk`hfd gd `hmdfk.

• Fdnr`phtkh gkhcdtkih i`mplkih dv`lutkh phikdftkl`r iu

gkhcdt zh"hrht htht tkpul # iht sk tkpul 3 kf mhk mult gd !5%gkf ihzurk guph #!$35 gd hfk gd dv`lutkd h c`lkk.

8

Fdnr`phtkh gkhcdtkih


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GdnfktkdGdnfktkd

• dnr`phtkh gkhcdtkih dstd ` c`hlh rdfhlh ir`fkih pr`jrdskvhihrd hphrd lh hpr`&kmhtkv #'9 gkftrd phikdftkk iu gkhcdtzh"hrht.

• dnr`phtkh gkhcdtki (FG) dstd ` i`mplkihtkd mkir`vhsiulhr hgkhcdtuluk zh"hrht $ G_ $ (tkp # shu 3).


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Fdnr`phtkk ihrd hphr iu nrdivdftä irdsiuth lh c`lfhvkkFdnr`phtkk ihrd hphr iu nrdivdftä irdsiuth lh c`lfhvkkgkhcdtkikgkhcdtkik

vdzkih fdur`l`jkiä

kfnditkkld urkfhrd ’ pkdl`fdnrktä hiutä/ir`fkiä

fdir`zh phpklhrä

Fdnr`hfjk`sildr`zh

Fdnr`phtkh ksiadmkih



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Hfht`mkd pht`l`jkihLdzkufk jl`mdrulhrd

- jl`mdrul`sildr`zh gknuzh?jl`mdrul`sildr`zh gknuzh?

- dxphfskufdh jl`chlh sk gkuzh h mhtrkidk mdzhfjkhld

- kfjr`shrdh mdmcrhfdk chzhld jl`mdrulhrd

- jl`mdrul`sildr`zh f`gulhrhjl`mdrul`sildr`zh f`gulhrh??- hiumulhrdh f`gulhrh kf mdzhfjku h ufuk mhtdrkhl

d`zkf`nl, hidlulhr, UHY p`zktkv



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Fdr`phtkh Gkhcdtkih - kst`l`jkd

(UHY, Q 755lhrjkrdh !knuzh h mdshfjkuluk iu akpdridlulhrkthtd mdshfjkhlh


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(UHY, Q "#5$kpdridlulhrkthtd mdzhfjkhlh !knuzh iu mkfkmd ldzkufd f`!ulhrd


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!muf`"u`rdsidfth# gdp`zktd jrhfulhrd kf mdzhfjkugd !j$



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%kir`si`pkd dlditr`fkih# kfjr`shrdh mdmcrhfdk chzhld

jl`mdrulhrd hdithfg mhk hlds lhmkfh gdfsh sk lhmkfh rhrh

kftdrfh sk gdp`zktd mdzhfjkhld



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(%&, Q '555 dphfskufdh mhtrkidk mdshfjkhld, kfjr̀ shrd lhmkfdk !dfsh h

mdm)rhfdk )hzhld jl`mdrulhrd


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Hfht`mkd pht`l`jkih

Ldzkufk tucul`-kftdrstktkhld#

- pkihturk mkik gd &khlkf kf tuckk pr`xkmhlk

- gdp`zktd gd jlki`jdf kf phrs rdith h tuculuk

pr`xkmhl 'ldzkufdh Hrmhfk-(cstdkf) - htr`nd tuculhrh

- ncr`zh kftdrstktkhlh



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Hfht`mkd pht`l`jkih

Ldzkufk vhsiulhrd#

- hrtdrk`sildr`zh

- hrtdrk`l`sildr`zh



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(*`l`rhtkd hrjdftkih, Q 755 dphfskufdh mhtrkidk mdshfjkhld, kfjr`shrdh mdm)rhfdk )hzhld,

hrtdrk`sildr`zh akhlhfh su)kftkmhlh htht lh fkvdlul hrtdrdk hndrdftd iht sk dndrdftd


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*hit`rk gd rksi

’ Nhit`rk nhmklkhlk?+ Hjrdjhrd nhmklkhlh+ ksi !d '-. Q mhk mhrd !d F, !hih hu uf nrhtd iu F

+ Urdvhldfth F dstd !d .- Q mhk mhrd lh fdjrkk sk aksphfkik vs8hl)kk f`f-aksphfkik

’ Gurhth dv`lutkdk G_ ’ I`ftr`lul jlkidmki?

+ Yih!d kfik!dfth+ d!uid rhth pr`jrdskdk F

’ AWH’ Numhtul?

+ ksiul hphrktkdk sk pr`jrdskdk F+ *rdstd rksiul #Q !d h nhid 3 tkp #

’ Gkslkpkgdmkh?+ Hiidldrdhzh pr`jrdskh FG

Fdnr`phtkh gkhcdtkih? Uht`jdfdzh


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+ 9hit`rk ihrd fu tkf !d struiturkld rdfhld ik !dmd!kul !kh)dtki ’ rkfkiak !d lh `m säfät`strhfsplhftht lh !kh)dtki ’ !dzv`ltä fdnr`phtkd f

hiddhsk pr`p`rtkd !d "/'’ rkfkiak !kh)dtki, iu fdnr`phtkd trhfsplhftht lhf`f-!kh)dtki 4> fdnr`phtkh (akst`l`jki!ksphrd



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+ Akpdrjlkidmkh’ Ur`guskk gd jlki`zklhrd fddfzkmhtkih sk dfzkmhtkih

+suft rdsp`fsh)klk !d ldzkufk lh fkvdlul `rjhfdl`rtkftä hitkvdhzh idlulh mdzhfjkhlh iu irdstdrdh skftdzdk sk

!dpufdrkk !d mhtrkid mdzhfjkhlh, stkmulhrdh pr`lkndrhrkkidlulhrd, irdstdrdh skftdzdk !d ikt`:kfd (d 1;9-)dth

hphrktkh ufuk ndf`tkp ?pr`-mhtrkid2 hl idluldk p`!`ikthrdiu irdstdrdh skftdzdk !d i`lhjdf tkp


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k` hs %H dt hl8 Gkhcdt dg8 #5"5 #E "5 "

1;9-)dth urkfhr


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Nkjurd 9. Gdvdl`pmdft `n gkhcdtds typd spdiknki urkfhry ck`mhrbdr phttdrf.

hh"s * +k,- /rjkls 8 drfh dt hl. (35#5) rkfhr- `llhjdf rhjmdfts /rd +kjfknkihftl- /ltdrdg kf *khcdtds4 / kf: t`

1ht"`p"-sk`l`j-. 1`+ ;? !(2)4 d#95!#. g`k4#5.#9


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(*`l`rhtkd hrjdftkih, Q 755 ldzkufk f`!ulhrd mdshfjkhld kmp`rthftd iu kfjr`shrd !knuzh h

mdm)rhfdk )hzhld jl`mdrulhrd


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Mhrbdrk gd gksnufitkd p`g`ikthrh

Fdnr`phtkh gkhcdtkih?


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+ Nhit`rk !dm`gkfhmkik?

’ AWH skstdmkih

’ Akpdr"ltrhrdh sk !kpdrpdrnuzkh jl`mdrulhrh?+ Hu n`st gdsirksd kf FG lh gdcut

+ Nhit`rk ihrd kfgui vhs`gklhthtkh hrtdrk`ldk hndrdftd?’ # !kpdrjlkidmkh$ H%&

’ # `'kgul fktrki

’ # nhit`rul fhtrkurdtki htrkhl

’ # !`rm`fk? jluihj`ful$ (%N#)

+ Nhit`rk ihrd kfgui vhs`i`fstrkitkh hrtdrk`ldk dndrdftd?’ # hfjk`tdfskfh$ U% vhs`i`fstrkit`hrd



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+ Nhit`rk !dm`gkfhmkik?

’ AWH skstdmkih

’ Akpdr"ltrhrdh sk !kpdrpdrnuzkh jl`mdrulhrh?+ *trds !dm`gkfhmki irdstdrdh skftdzdk gd mhtrkid

d'trhidlulhrh sk gd nhit`rk gd irdstdrd gd ihtrd idluldlddfg`tdlkhld sk mdzhfjkhld

+ Gdfughrdh dfg`tdlkuluk

+ +dzhrdh dpktdlkuluk p`g`ikthr + Ur`tdkfurkd ldzkufd tuculhrh$ kf,hmhtkd sk "cr`zh

tucul`#kftdrstktkhlh



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F n tk gk c tk U t


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+ Nhit`rk jdfdtkik?

’ %df`tkpul GG hl jdfdk &IH’ %dfdld A+H H- rksi gd gùh `rk mhk mhrd gd h gdzv`lth

FG’ %dfdld A+H G./ sk G.5 sd hsìkhzh iu rksi sihzut gd FG

+ Nhit`rk !`rm`fhlk?

’ Hitkvkthtdh irdsiuth kftrhrdfhlh h *.H+ Akpdrjlkidmkh stkmuldhzh pr`guitkh gd Hj(( gd ihtrd idlulh

mdzhfjkhlh+ Hj (( dndit vhsì`fstrkit`r sk dnditd pr`kf,hmht`rkk sk

mkt`jdfd



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!khjf`stkiul 3

!urhth 3

hs`ikdrdh iu hltd n`rmd !d mkir`hfjk`phtkd

(rdtkf`phtkd, fdur`phtkd

$1H

Ur`tdkfurkd (mkir`hl)umkfurkd

hltdrhrdh nufitkdk rdfhld

Fdnr`phtkh gkhcdtkih? Gkhjf`stki


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*dsk hlcumkfurkh dstd uf mhr:dr utkl kf gkhjf`stkiul

fdnr`phtkdk gkhcdtkid ih kfgkiht`r gd pr`jrdskd hfdnr`phtkdk gkhcdtkid hlcumkfurkh dstd mult mhk pu kf utkl=Ȓnkkfg lkpskth gd sdfskcklkthtd sk spdiknkikthtd.

* p`htd dv`luh nrdivdft nhrh irdstdrdh hlcumkfurkdk ski"khr kf i`fgktkk gd f`rm`hlcumkfurkd6

+$`vkf! U dt hl8 838 #5570'#C(E77C

lcumkfurkh

Fdnr`phtkh gkhcdtkih? Gkhjf`stki


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!hikdft kf vhrsth gd "# gd hfk iu G_ tkp $% pr`tdkfurkd

sdvdrh (& '#j$a) sk nufitkd rdfhlh f`rmhlh


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- Hndithrd rdfhlh- Yumhr gd urkfh# jlki`zurkd, hlcumkfurkd- sdgkmdft urkfhr shrhi-pr`tdkfurkd (gd rhfj fdnr`tki kf sthgkkld hvhfshtdhld FG)

- Nufitkh rdfhlh - f`rmhlh shu irdsiuth kf prkmkk hfk gd dv`lutkd hkFG - *$ pr`jrdskvh

- Skfkiak f`rmhlk di`jrhi

Fdr`phtkh gkhcdtkih

%hfkdsthrk ilkfkid- Akpdrtdfskufdh hrtdrkhlh

http://www.google.ro/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=NdF6LPDYBZq7vM&tbnid=xDDaQCTj37jkKM:&ved=0CAcQjRw&url=http://it.wikipedia.org/wiki/Nefropatia_diabetica&ei=Y38oVO7dN6HhywPMkYCQAw&bvm=bv.76247554,d.bGQ&psig=AFQjCNHCvKIjVPHk9f8BxiPWFWp_l_3yGg&ust=1412026224538773http://www.google.ro/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=NdF6LPDYBZq7vM&tbnid=xDDaQCTj37jkKM:&ved=0CAcQjRw&url=http://it.wikipedia.org/wiki/Nefropatia_diabetica&ei=Y38oVO7dN6HhywPMkYCQAw&bvm=bv.76247554,d.bGQ&psig=AFQjCNHCvKIjVPHk9f8BxiPWFWp_l_3yGg&ust=1412026224538773


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.kriumsthftd ilkfkid ihrd hi kmpr`chckl/ fdr`phtkhgkhcdtki/#

’ kftdrvhl !d tkmp siurs !d lh !d)ut I . hfk’ h)sdfth rdtkf`phtkdk !kh)dtkid sk h hlt`r i`mplkihtkk

mkir`vhsiulhrd

’ !kmdfskufk hld rkfkiakl`r !ksi`r!hftd iu sth!kul fdnr`phtkdk’ admhturkd iu drktr`iktd !ksm`rGid sk iklkf!rkk drktr`ikthrk’ *rdstdrdh rhpk!h h fkvdluluk pr`tdkfurkdk ( kf ihtdvh shpthmhfk’ Ur`tdkfurkd mhskvh > . j/ #7a’


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+ dzdiaklk)rul mdth)`lkidzdiaklk)rul mdth)`lki

+ $1H$1H

+ Ur`tdkfurkhUr`tdkfurkh

+ 9umhtul9umhtul

+ Hp`rtul !d shrdHp`rtul !d shrd

+ kslkpk!dmkhkslkpk!dmkh

+ *`fsumul !d su)st8 fdnr`t`kid*`fsumul !d su)st8 fdnr`t`kid

Fdnr`phtkh gkhcdtkih? Nhit`rk gd hjrhvdzd


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F`f nhrmhi`l`jki+ H!hpthrdh rhtkdk jluik!kid+ Yiä!drdh rhtkdk pr`tdkid sk h hp`rtuluk !d s`!ku+ &vkthrdh su)sthftdl`r fdnr`t`kid hmkf`jlki`zk!d, su)sthfDd !d

i`ftrhst iu k`! (akpdr`sm`tkid, hfhljdzkid fdstdr`k!kdfd+ Yih!drd p`f!drhlh

+ Nprkrdh numhtuluk, sih!d rhth !d pr`jrdskd h F iu '5J

Nhrmhi`l`jki

"8 *`ftr`lul jlkidmkdk*`ftr`lul jlkidmkdk’ *`ftr`lul strkit hl jlkidmkdk iu `)tkfdrdh ufdk i`fidftrhtkk h

adm`jl`)kfdk jlkihtd $A H"* su) EJ !uid lh siä!drdh rksiulukhphrkDkdk F iu '. - .5J

#8#8 Yiä!drdh 1H skstdmkidYiä!drdh 1H skstdmkid

Fdnr`phtkh gkhcdtkih? Wrhthmdft


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'8 Yiä!drdh prdskufkk shfjukfd kftrhjl`mdrulhrdprdskufkk shfjukfd kftrhjl`mdrulhrd prkf siä!drdht`fusuluk musiulhr lh fkvdlul hrtdrk`ldk dndrdftd

+ Y-h !`vd!kt iä siä!drdh prdskufkk kftrhjl`mdrulhrd hrd ufdndit pr`tditkv f fdnr`phtkh !kh)dtkiä kf!dpdf!dft skiumulhtkv iu i`ftr`lul prdskufkk hrtdrkhld skstdmkid

+ äspufsul lh trhthmdft sd m`fkt`rkzdhzä prkf dirdtkhurkfhrä !d hl)umkfä

h5 Hgmkfkstrhrdh gd !(H.Hgmkfkstrhrdh gd !(H.’ sih!d rksiul !d !dtdrk`hrd h nufitkdk rdfhld (!u)lhrdh

irdhtkfkfdmkdk iu 7CJ’ sih!d rksiul !d !dids shu urdmkd iu .5J’ dnditul dstd kf!dpdf!dft !d vhl`rkld 1H skstdmkid

c5 Hgmkfkstrhrdh gd cl`ihftk hk H !!cl`ihftk hk H !! - dnihikthtd 3fstugkk


F n k gk c k W


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g5 %dgkihtkd hg9uvhft/

’ akp`lkpdmkhftd, akp`i`ldstdr`ldmkhftd

’ hftkhjrdjhftd plhiadthrd

’ trhthmdftul pr`mpt hl idl`rlhltd i`mplkihtkk hld !kh)dtuluksk f spdikhl h idl`r kfnditk`hsdc`lfhvk iu i`mpdtdft/ kmuf`l`jki/ lkmktht/ 7

d5 %dgkihtkd hftkncr`tkih# hftk $*-4dth 'Ukrdfkg`fh)

H!mkfkstrhrdh !d su)sthftd !d i`ftrhst `sm`tki hitkvdKH!mkfkstrhrdh !d su)sthftd !d i`ftrhst `sm`tki hitkvdKghi/ hgmkfkstrhrdh gd sucsthftd gd i`ftrhst `sm`tkihitkvd dstd strkit fdidshr/ 'dx5 i`r`fhr`jrhnd)dxhmdful sd vh hid 3f i`fgk>kk gd &kgrhthrd i`mpldt/&kgrhthrd i`mpldt/



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Date post:	07-Jul-2018
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Curs Dr. Ismail ND 2013

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