executive summary of recommendations management · pdf file2 2 table 5 c history, physical...
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7002/2 SENILEDIUG ECITCARP LACINILC HOM
sitirhpenoluremolG
snoitadnemmocer fo yrammus evitucexEniam eht ni dnuof eb nac snoitadnemmocer fo sliateD .detacidni segap eht ta txet
airunietorp dna airutameah fo tnemeganaM
C rp dna airutameah cipocsorcim tceted ot gnineercS ni airunietoevewoH .dednemmocer ton si noitalupop citamotpmysa gnisu gnineercs ,r
ta slaudividni rof enod eb dluohs sisylana kcitspid esaesid yendik rof ksir .)03 gp(
VI leveL ,C edarG
B >( airutameah cipocsorcim htiw stneitaP 3 ogrednu dluohs )fph/sCBR( esaesid tcart yraniru/laner edulcxe ot noitaulave .)03 gp
III leveL ,B edarG
B noc dradnats rednu ypocsorcim tsartnoc esahp enirU ni lufesu si snoitidruos raluremolg-non morf raluremolg gnitaitnereffid .)03 gp( airutameah fo sec
III leveL ,B edarG
B detaulave eb dluohs airutameahorcim htiw stneitaP fo ecneserp eht rof gp( tnemriapmi laner dna airunietorp ,noisnetrepyh .)03
III leveL ,B edarG
B airutameahorcim raluremolg detalosi htiw stneitaP -wollof no niamer dluohsrusserp doolb rotinom ot slavretni htnom 21-6 ta pu laner dna airunietorp ,e
.)13 gp( noitcnufIII leveL ,B edarG
B ro raluremolg-non fo airutameahorcim htiw stneitaP ogrednu dluohs nigi)13 gp( esaesid tcart yraniru edulcxe ot noitaulave .
III leveL ,B edarG
Academy of Medicine,Singapore
Chapter of Renal PhysiciansCollege of Physicians, Singapore
College of Family Physicians, Singapore
MINISTRY OF HEALTH SINGAPORE
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5 elbaT C yrotarobal dna noitanimaxe lacisyhp ,yrotsiH airutameah htiw stneitap rof noitaulave
yrotsiH :smotpmyS yranirU
• ycneuqerf ,airusyD• airutameah ssorg suoiverP• ciloc laner ro cireterU• s noitcurtsbo teltuo reddalb fo evitseggus smotpmyS dna maerts roop sa hcu
gnilbbird :yrotsiH lacideM tsaP
• sesaesid enummiotuA• yparehtoidar lacigolocno civleP• teru ot gnisopsid-erp sesaesid dettimsnart yllauxeS erutcirts larhteru dna sitirh• amuart laneR• sisolucrebut laner-artxe ro laner suoiverP• snoitcefni tcart yraniru reppu ro rewoL
:yrotsiH gurD• nirafraW• sgurd yrotammalfni itna ladiorets-noN• ypareht evisserppusonummi/cixototyc suoiverP• el ,senima citamora ,enezneb( slacimehc ot erusopxE ni slacimehc ,seyd rehta
)erutcafunam eryt ro rebbur• gnikoms etteragiC• maxe( seidemer gnimmils labreh gnimusnoc fo yrotsiH gniniatnoc esoht :elp
)dica cilohcotsira• caer kcitspid evitisop eslaf a esuac yam taht sgurD niatrec sa hcus noit
snoitulos citpesitna :fo yrotsiH ylimaF
• esaesid laner yramirP• noisnetrepyH• )DKCPA( esaesid yendik citsycylop tludA• emordnys sʼtroplA fo evitseggus ssenfaeD• sisaihtilorU• airutameah cipocsorciM
3 3
)tʼnoc( 5 elbaT)tʼnoc( yrotsiH
:rehtO• ro )ITRU( noitcefni tcart yrotaripser reppu tneceR gnitseggus sitillisnot
sitirhpenoluremolg suoitcefni-tsop• nitseggus ,)EG( sitiretneortsag ro/dna ITRU gniognO yhtaporhpen A gI g• aiglarhtra ,aiglaym sa hcus smotpmys lanoitutitsnoC ,hsar suoenatuc dna
ciretnecserc ro aruprup nielnohcS-hconeH gnitseggus sitirhpenoluremolg • yhtaporhpen citebaid dna sutillem setebaiD• sisehtaid gnideelb a fo ecnedivE
airutameaH htiw stneitaP rof noitanimaxE lacisyhP erusserp doolB
sitilucsav latigid ,aruprup rof noitanimaxe nikS noitcepsni lisnot/taorhT
srumrum rof noitatlucsua caidraC daolrevo diulf fo sngiS
ndik elbatollab ,degralne rof noitanimaxe lanimodbA rehto ro sye ylagemonagro
selam ni etatsorp eht fo noitanimaxe latcer latigiD
htiw stneitaP rof snoitagitsevnI yrotarobaL laitinI airutameaH tnuoc doolb lluF
le dna eninitaerc ,aeru mures :stset noitcnuf laneR setylortce erutluc enirU
• s snoitcefni tcart yraniru nevorp yllacigoloiborcim detaert eb tsrif dluoh era stset rehtruf erofeb dekcehc-er sisylaniru dna enod
ypocsorcim tsartnoc esahp enirU nietorp yraniru ruoh-42( tnemerusaem nietorp enirU eninitaerc / nietorp eniru ro
)oitar
)33-23 gp( VI leveL ,C edarG
C ru suonevartni ,snoitacidniartnoc fo ecnesba eht nI eht si )UVI( yhpargoagitsevni rof eciohc fo gnigami laitini dednemmocer raluremolg-non fo noityhpargonosartlu yb detnemelpmoc eb yam dna gnideelb .)43 gp(
VI leveL ,C edarG
B doog a evah airunietorp citatsohtro htiw stneitaP ton od dna sisongorp laner .q)43 gp( pu-wollof eriuqer
III leveL ,B edarG
4 4
B rof detaulave eb dluohs airunietorp htiw stneitaP fo ecneserp eht tnemriapmi laner dna noisnetrepyh ,airutameahorcim .)43 gp(
III leveL ,B edarG
B ah airunietorp detalosi tnettimretni htiw stneitaP laner elbaruovaf a evoituloser litnu pu dewollof eb dluohs tub sisongorp .)53 gp( airunietorp fo n
III leveL ,B edarG
B uohs airunietorp detalosi tnetsisrep htiw stneitaP pu-dewollof eb dl dna erusserp doolb fo gnirotinom htiw yletinifedni ksir eht ecnis noitcnuf laner
h si ycneiciffusni laner gnipoleved yltneuqesbus fo .)53 gp( rehgiIII leveL ,B edarG
B > airunietorp tnetsisrep htiw stneitaP yspoib laner ogrednu dluohs yad/g 1 golohtapotsih laner esrevda rof ksir ta era yeht sa laner esrow erofereht dna y
.)53 gp( emoctuoIII leveL ,B edarG
6 elbaT PPG dna noitanimaxe lacisyhp ,yrotsiH airunietorp htiw stneitap rof noitaulave yrotarobal
:yrotsiH :smotpmyS yranirU
• itcefni tcart yraniru edulcxe ot ycneuqerf ,airusyd no :fo yrotsiH lacideM tsaP
• sitirhpenoluremolg doohdlihc• nemow ni aispmalce-erp• snoitidnoc enummiotua• setebaid• eruliaf caidrac
:yrotsiH gurD• es ot noitaler ni lirpotpac dna enimallicinep ,dlog yradnoc
yhtaporhpen suonarbmem• p ro )SDIASN( sgurd yrotammalfni-itna ladiorets-noN ni snillicine
sitirhpen laititsretni )cigrella( ot noitaler
5 5
)tʼnoc( 6 elbaT:noitanimaxE lacisyhP
erusserp doolB noisnetrepyh ot eud egamad nagro dne fo sngiS
eruliaf laner fo sngiS esaesid enummi-otua ro setebaid fo sngiS
amedeO:snoitagitsevnI yrotarobaL laitinI
la ton fi( airusocylg dna airutameah rof sisylanirU )demrofrep ydaer erutluc rof nemiceps eniru maerts-dim hserF
eht ni( esoculg gnitsaf dna eninitaerc ,aeru mureS fo ecneserp )airusocylg
nimubla mureSuoh-42( noitacifitnauq rof noitcelloc eniru ruoh-42 )PTU r
rousaem eninitaerc dna nietorp yraniru tops ro modnaR evired ot tnemer
> RCP .)RCP( oitar eninitaerc/nietorp yraniru eht setacidni g/gm 002 .tnetnoc nietorp eniru detavele
54> stcejbus ni yhtapommag lanolconom fo noisulcxE ega fo sraeydna erutcurts etaulave ot syendik eht fo dnuosartlU ezis
ypocsorcim tsartnoc esahp enirU )TCC( ecnaraelc eninitaerc yraniru ruoh-42
ro noitaluclaC )RFG( etaR noitartliF raluremolG
:noitaulavE lacigolorhpeN> airunetorp fi yspoib laneR laner gninesrow yldipar ro/dna yad/g 1
er htob( sesuac rehto fo ecnesba eht ni noitcnufsyd cimetsys dna lan )sesuac
)73-63 gp( PPG
B runietorp rehtie dna airutameahorcim htiw stneitaP ro ai ro noisnetrepyh igolorhpen a ot derrefer eb dluohs tnemriapmi laner gp( noitaulave rehtruf rof ts
.)73 III leveL ,B edarG
6 6
B ulave eb dluohs airutameah ssorg htiw stneitap llA lacigoloru rof detaevartni ,dnuosartlu fo noitanibmoc a htiw ygolohtap dna yhpargoru suon
.)83 gp( ypocsorhteruotsyc elbixelf III leveL ,B edarG
htiw stneitaP fo tnemeganaM ni serusaeM lareneGsitirhpenoluremolG
A etaulave eb dluohs sitirhpenoluremolg htiw stneitaP fo epyt eht hsilbatse ot d24 gp( ytireves sti yfitnedi dna sitirhpenoluremolg .)
bI leveL ,A edarG
A orp fo eerged ,noitcnuf laner fo level rof gnitseT dna yspoib laner ,airuniettacidni sa demrofrep eb dluohs snoitagitsevni rehto de .)24 gp(
bI leveL ,A edarG
C issergorp ssessa ot pu dewollof eb dluohs stneitaP .sitirhpenoluremolg fo nolR luohs srekram rehto dna airunietorp ,noitcnuf aneR wollof no derotinom eb d
dna sitirhpenoluremolg fo epyt yb detacidni sa ,pu ehT .noitidnoc fo ytirevessab deifitnedi eb dluohs esaesid yendik fo ytireves .)24 gp( srekram eseht no de
VI leveL ,C edarG
A i eb dluohs sitirhpenoluremolg fo ypareht cificepS yb detacidni sa detutitsn .)44 gp( noitidnoc gniylrednu fo ytireves dna epyt
aI leveL ,A edarG
A rp fo etar eht stciderp airunietorp fo level eht sA ,esaesid laner fo noissergoorp ecuder ot detutitsni eb dluohs serusaem lareneg htiw stneitap ni airuniet
.)44 gp( sitirhpenoluremolg aI leveL ,A edarG
A eb dluohs srotibihni emyzne gnitrevnoc nisnetoignA ecuder ot desu ecnesba eht ni ,noissergorp drater dna airunietorp stneitap ni ,noisnetrepyh fo
5.)54 gp( sitirhpenoluremolg htiw aI leveL ,A edarG
B tla na sa desu eb nac srekcolb rotpecer nisnetoignA nisnetoignA ot evitanre airunietorp ecuder ot srotibihni emyzne gnitrevnoc ni noissergorp drater dna
.)54 gp( sitirhpenoluremolg htiw stneitap bII leveL ,B edarG
7 7
A moc eb nac srotibihni emyzne gnitrevnoc nisnetoignA htiw denibairunietorp ecuder ot srekcolb rotpecer nisnetoignA ni noissergorp drater dna
.)54 gp( sitirhpenoluremolg htiw stneitap bI leveL ,A edarG
B t htiw yad/g 5.0 < ot decuder eb dluohs airunietorP htiw stneitap ni ypareh.)64 gp( sitirhpenoluremolg
III leveL ,B edarG
PPG eruliaf laner dna sitirhpenoluremolg htiw stneitaP ,)nim/Lm 52< RFG(ive on evah dna sisylaid ecnanetniam no ton era ohw ,noitirtunlam fo ecned
p- idivorp teid nietor-wol a rof deredisnoc eb dluohs ydob gk/nietorp g 8.0 gn dluohs nietorp yrateid fo %05 tsael tA .yad/thgiew eulav cigoloib hgih fo eb
.)64 gp( PPG
C ocer si yad/thgiew ydob gk/lack 53 gnidivorp teid A stneitap ni dednemmuen niatniam ot )nim/Lm 52< RFG( eruliaf laner htiw ot ,ecnalab negortin lartrom dna snoitartnecnoc nimubla mures rehgih etomorp cirtemoporhtna lamron e
.)74 gp( sretemarap VI leveL ,C edarG
htiw stneitaP ni noisnetrepyH fo tnemeganaMsitirhpenoluremolG
A > erusserp doolb sa denifed ,noisnetrepyH detaert eb dluohs ,gH mm 09/041ter ot redro ni sitirhpenoluremolg htiw stneitap ni fo noitaroireted fo etar eht dra
.)84 gp( noitcnuf laneraI leveL ,A edarG
C lg htiw stneitap ni detaert eb dluohs noisnetrepyH ot sa os sitirhpenoluremo.)84 gp( esaesid ralucsavoidrac rof ksir eht ecuder
VI leveL ,C edarG
A aeM( gH mm 08/031 naht ssel erusserp doolb tegrat A erusserp lairetra nuremolg htiw stneitap rof dednemmocer si )gH mm 89< dna sitirhpenol
< airunietorp .)94 gp( yad/g 1 aI leveL ,A edarG
8 8
A eM( gH mm 57/521 naht ssel erusserp doolb tegrat A 29< erusserp lairetra naenoluremolg htiw stneitap rof dednemmocer si )gH mm airunietorp dna sitirhp
.)94 gp( yad/g 1> aI leveL ,A edarG
A eriuqer eb yam gurd evisnetrepyh-itna eno naht eroM tegrat eveihca ot dsitirhpenoluremolg htiw stneitap ni erusserp doolb 50 .) gp(
bI leveL ,A edarG
A lortnoc ot desu eb yam tnega evisnetrepyh-itna ynA ni erusserp doolb .)05 gp( sitirhpenoluremolg htiw stneitap
aI leveL ,A edarG
A mmocer era srotibihni emyzne gnitrevnoc nisnetoignA derreferp sa dedneluremolg htiw stneitap ni noisnetrepyh fo tnemtaert refnoc yeht sa sitirhpeno
noitcetorponer retaerg .)05 gp( aI leveL ,A edarG
B a na sa desu eb nac srekcolb rotpecer nisnetoignA nisnetoignA ot evitanretl noisnetrepyh taert ot srotibihni emyzne gnitrevnoc htiw stneitap ni
sitirhpenoluremolg .)15 gp( aII leveL ,B edarG
B bmoc ni desu eb yam srekcolb rotpecer nisnetoignA nisnetoignA htiw noitani noisnetrepyh taert ot srotibihni emyzne gnitrevnoc htiw stneitap ni
.)15 gp( sitirhpenoluremolg aII leveL ,B edarG
A 2 derreferp era sciteruiD dn htiw stneitap ni stnega evisnetrepyhitna enil drac rof ksir eht ecuder yeht sa sitirhpenoluremolg .)25 gp( esaesid ralucsavoi
b1 leveL ,A edarG
B eb nac srekcolb lennahc muiclac dna srekcolb ateB ot ylevitanretla desuenoluremolg htiw stneitap ni erusserp doolb lortnoc .)35 gp( sitirhp
aII leveL ,B edarG
C oenatlumis nugeb eb dluohs snoitacifidom elytsefiL a fo trap sa ylsu dna erusserp doolb rewol ot ygetarts evisneherpmoc ksir ralucsavoidrac
.)35 gp( VI leveL ,C edarG
9 9
C s sitirhpenoluremolg dna noisnetrepyh htiw stneitaP derotinom eb dluohel dna noitcnuf laner ,erusserp doolb rof ylraluger airunietorp fo lev .)45 gp(
VI leveL ,C edarG
C emyzne gnitrevnoc nisnetoignA na gniviecer stneitaP ro rotibihni of derotinom eb dluohs rekcolb rotpecer nisnetoignA laner ni esaerced r
aimealakrepyh dna noitcnuf .)45 gp( VI leveL ,C edarG
C etoignA ro srotibihni emyzne gnitrevnoc nisnetoignA srekcolb rotpecer nisnlaner ni esaerced htiw stneitap ni deunitnoc eb nac 4 revo %03< fo noitcnuf
< muissatop mures ro shtnom .)45 gp( L/lomm 5.5 VI leveL ,C edarG
C etoignA ro srotibihni emyzne gnitrevnoc nisnetoignA srekcolb rotpecer nisnesoht ni ro stneitap tnangerp ni desu eb ton dluohs -- decudnigurd htiw
TT iw desu eb osla dluohs yeh .ygrella ro amedeaoigna htiw stneitap ni noituac ht5 gp( aimealakrepyh ereves ro sisonets yretra laner .)4
VI leveL ,C edarG
htiw stneitaP ni noitcnufsyD laneR fo tnemeganaM sitirhpenoluremolG
B molg detamitse dna sitirhpenoluremolg htiw stneitaP etar noitartlif ralurem 37.1/nim/Lm 06< 2 liaf laner fo snoitacilpmoc rof dessessa eb dluohs ,eru
.)65 gp( esaesid enob dna aimeana gnidulcni III leveL ,B edarG
C erotinom eb dluohs sitirhpenoluremolg htiw stneitaP fo snoitacilpmoc rof davoidrac rof srotcaf ksir ,noitidnoc gniylrednu eht edis dna esaesid ralucs
.)65 gp( ypareht fo stceffe VI leveL ,C edarG
B detaitini eb dluohs noitcnufsyd laner htiw stneitaP tnemecalper laner no eruliaf laner fo smotpmys yb detacidni nehw ypareht lacimehcoib ro/dna
.)75 gp( snoitagitsevni III leveL ,B edarG
B olg detamitse dna sitirhpenoluremolg htiw stneitaP etar noitartlif raluremm 37.1/nim/Lm 06< 2 yb aimeana fo ecneserp eht rof detaulave eb dluohs
.)75 gp( yllacidoirep nibolgomeah gnirusaem III leveL ,B edarG
10 01
B detaitini eb dluohs aimeana fo noitaulave rehtruF htiw stneitap ni:nehw noitcnufsyd laner dna sitirhpenoluremolg
• na selamef lasuaponem-erp ni Ld/g 11< si nibolgomeH latrebuperp d stneitap
• uaponem-tsop dna selam tluda ni Ld/g 21< nibolgomeH .selamef las )85 gp(
III leveL ,B edarG
B edulcni dluohs aimeana fo noitaulavE • secidni llec deR• tnuoc etycoluciteR• paC gnidniB norI latoT ,nori mures( sretemarap norI tnecrep ,ytica
)nitirref mures dna noitarutas nirrefsnart• .sloots ni doolb tlucco rof stseT
)85 gp( III leveL ,B edarG
A ohs noitcnufsyd laner ot eud aimeana htiw stneitaP htiw detaert eb dlus nirrefsnart tnecrep niatniam ot nori latnemelppus mures dna %02> noitaruta
.)85 gp( Lm/gn 001> level nitirref bI leveL ,A edarG
A detaert eb dluohs noitcnufsyd laner ot eud aimeanA niteioporhtyre htiw .)85 gp( ypareht
aI leveL ,A edarG
A syd laner htiw stneitap rof nibolgomeah rof tegraT 21 eb dluohs noitcnufporhtyre rof era nibolgomeah rof egnar tegraT .Ld/g ton era dna ypareht niteio
9 .)5 gp( noisufsnart doolb rof noitacidni na aI leveL ,A edarG
B nidulcni ypareht niteioporhtyre fo stceffe esrevdA eb dluohs noisnetrepyh gr dna sitirhpenoluremolg htiw stneitap ni derotinom .)95 gp( noitcnufsyd lane
III leveL ,B edarG
B salp tcatni dna surohpsohp ,muiclac fo slevel mureS enomroh dioryhtarap amluremolg htiw stneitap ni derusaem eb dluohs slevel GG 06< RFe dna sitirhpeno
m 373.1/nim/Lm 2 .)06 gp( III leveL ,B edarG
11 11
B laner cinorhc dna sitirhpenoluremolg htiw stneitaP dluohs noitcnufsydmuiclac ,etahpsohp mures lortnoc ot ypareht eviecer enomroh dioryhtarap dna
t eud esaesid enob fo tesno ecuder ot sa os ,slevel yradnoces o.)06 gp( msidioryhtaraprepyh
III leveL ,B edarG
C el enomroh dioryhtarap dna etahpsohp ,muiclac mureS eb dluohs slevtiw stneitap ni slavretni ylhtnom 21-3 ta derotinom dna sitirhpenoluremolg h
.)06 gp( noitcnufsyd laner cinorhc VI leveL ,C edarG
C a 7.2 neewteb deniatniam eb dluohs slevel etahpsohP 78.0( Ld/gm 6.4 dnsyd laner cinorhc htiw stneitap ni )L/lomm 94.1 dna .)16 gp( noitcnuf
VI leveL ,C edarG
B 0001-008 ot detcirtser eb dluohs etahpsohp yrateiD rof detsujda( yad/gm slevel etahpsohp mures nehw )sdeen nietorp yrateid 6.4 evoba detavele era
tavele era slevel enomroh dioryhtarap nehw ro Ld/gm .)16 gp( de III leveL ,B edarG
C ipsed dellortnoc eb tonnac level etahpsohp mures fI etahpsohp yrateid etdebircserp eb dluohs srednib-etahpsohp ,noitcirtser .)16 gp(
VI leveL ,C edarG
C ewol ot desu eb nac srednib etahpsohp desab-muiclaC etahpsohp mures r .)16 gp( slevel
VI leveL ,C edarG
C lac yb dedivorp muiclac latnemele fo esod latot ehT etahpsohp desab-muicatot eht dna yad/gm 005,1 deecxe ton dluohs srednib latnemele fo ekatni l
ecxe ton dluohs )muiclac yrateid gnidulcni( muiclac .)16 gp( yad/gm 000,2 de VI leveL ,C edarG
C t nihtiw deniatniam eb dluohs slevel muiclac mureS 5.9 ot 4.8 fo egnar ehacrepyh diova ot sa os ,)L/lomm 73.2 ot 01.2( Ld/gm .)26 gp( aimeacl
VI leveL ,C edarG
C detaluclac eb dluohs tcudorp etahpsohp-muiclac ehT morf ,yllacidoirep stneitap ni ,etahpsohp dna muiclac mures fo seulav sitirhpenoluremolg htiw
.)26 gp( noitcnufsyd laner cinorhc dnaVI leveL ,C edarG
12 21
C si tcudorp etahpsohp-muiclac detaluclac tegrat ehT gm ni( 55 2 Ld/ 2 ni )c fo sesoD .noitcnufsyd laner cinorhc htiw stneitap D nimatiV dna muicla
etahpsohp–muiclac eht fi decuder eb dluohs sgolana tegrat eht sdeecxe tcudorp .)26 gp( egnar
VI leveL ,C edarG
PPG i level enomroh dioryhtarap tcatnI fo egnar tegraT htiw stneitap nwoleb detsil sa eb dluohs noitcnufsyd laner cinorhc :)26 gp(
m 37.1/nim/Lm( RFG 2 )L/lomp( HTP tcatni tegraT )
95-03 07.7-58.3 92-51 01.21-07.7
PPG
A tavele dna noitcnufsyd laner cinorhc htiw stneitaP enomroh dioryhtarap deiw detaert eb dluohs segnar tegrat eht evoba slevel slorets D nimativ evitca ht
.)26 gp( bI leveL ,A edarG
C tavele rof slorets D nimativ evitca htiw tnemtaerT enomroh dioryhtarap des noitcnufsyd laner cinorhc htiw stneitap ni slevel ni ylno nekatrednu eb dluohiclac latot mures detcerroc fo slevel htiw stneitap mures dna Ld/gm 5.9 < mu
.)36 gp( Ld/gm 6.4 < etahpsohpVI leveL ,C edarG
C cnufsyd laner dna sitirhpenoluremolg htiw stneitaP detaulave eb dluohs noitipil etelpmoc a evah dluohs yehT .aimeadipilsyd rof gnidulcni eliforp d
h dna nietorpopil ytisned-wol ,latot ,sedirecylgirt nietorpopil ytisned-hgi .)36 gp( loretselohc
VI leveL ,C edarG
A b dluohs slevel loretselohc detavele htiw stneitaP ecuder ot sa os detaert eneitap rof sa esaesid ralucsavoidrac rof ksir rieht .noitalupop lareneg eht ni st
r-loretselohc htiw detaert eb dluohs stneitap esehT snitats dna teid gnicude .)46 gp(
aI leveL ,A edarG
A b dluohs slevel loretselohc detavele htiw stneitaP sa os snitats htiw detaert eaesid laner fo noissergorp rof ksir rieht ecuder ot .)46 gp( es
aI leveL ,A edarG
13 31
C neitap ni ypareht htiw loretselohc LDL rof stegraT htiw stgm 001< si noitcnufsyd laner dna sitirhpenoluremolg .)56 gp( Ld/
VI leveL ,C edarG
C itap ni derusaem eb dluohs level etanobracib mureS htiw stned ot sa os noitcnufsyd laner dna sitirhpenoluremolg .)56 gp( sisodica tcete
VI leveL ,C edarG
B < level etanobracib mures( sisodica htiw stneitaP eb dluohs )L/lomm 51 .etanobracib muidos sa hcus ilakla na htiw detaert etanobracib mures tegraT
.)56 gp( L/lomm 22> si ypareht htiw level III leveL ,B edarG
stludA ni esaesiD egnahC laminiM fo tnemeganaM
B hc laminim ot eud emordnys citorhpen htiw stneitaP eb dluohs esaesid egnap( airunietorp fo noissimer ecudni ot sa os detaert .)76 g
III leveL ,B edarG
A laitini rof dednemmocer si enolosinderp esod hgiH citorhpen fo tnemtaert .)96 gp( esaesid egnahc laminim ot eud emordnys
bI leveL ,A edarG
B nemmocer si yad/gk/gm 1 ta enolosinderp laro yliaD tnemtaert laitini rof dedesaesid egnahc laminim ot eud emordnys citorhpen fo .)96 gp(
III leveL ,B edarG
B nac yad/gk/gm 2 ta enolosinderp laro yad-etanretlA laitini rof desu eb nahc laminim ot eud emordnys citorhpen fo tnemtaert .)07 gp( esaesid eg
III leveL ,B edarG
B si ereht fi deredisnoc eb dluohs ecnatsiser dioretS eveihca ot eruliaf nahc laminim ot eud emordnys citorhpen fo noissimer skeew 61 yb esaesid eg
.)07 gp( ypareht dioretsocitroc fo noitaitini retfa III leveL ,B edarG
PPG nu deunitnoc eb dluohs esod enolosinderp esod hgiH si noissimer litatsiser diorets ro yticixot diorets sselnu deveihca .)17 gp( desongaid si ecn
PPG
14 41
A oissimer retfa derepat eb dluohs esod enolosinderP emordnys citorhpen ni ngnirepaT .deunitnocsid yltneuqesbus dna deveihca si eb dluohs enolosinderp fo
.)17 gp( shtnom 6 revo demrofrep bI leveL ,A edarG
B su eb nac enolosinderp yad-etanretla ,repat gniruD edis eht eziminim ot de.)17 gp( ypareht fo stceffe
III leveL ,B edarG
B m eb dluohs repat enolosinderp gniogrednu stneitaP fo espaler rof derotino .)17 gp( emordnys citorhpen
III leveL ,B edarG
B nys citorhpen fo espaler a ecneirepxe ohw stneitaP a gniwollof emordfo esruoc dnoces a htiw detaert eb dluohs noissimer .)17 gp( sdioretsocitroc
III leveL ,B edarG
PPG hc laminim ot eud emordnys citorhpen htiw stneitaP dluohs esaesid egnaP .sdioretsocitroc fo stceffe edis rof derotinom eb eb dluohs sesod enolosinder
eht fi deredisnoc tnemtaert evitanretla dna decuder diorets elbatpeccanu si er gp( desongaid si ecnatsiser diorets fi ro yticixot .)27
PPG
B desu eb nac edimahpsohpolcyc htiw ypareht cixototyC fo tnemtaert rof citorhpen tnedneped-diorets ro gnispaler yltneuqerf laminim ot eud emordnys
.)27 gp( esaesid egnahc III leveL ,B edarG
PPG nnalp si ypareht edimahpsohpolcyc mohw ni stneitaP eb dluohs deam dna ytilirets rof ksir laitnetop eht fo demrofni dluohs stneitap elaM .ycnangil
.)37 gp( egarots mreps redisnoc ot desivda eb PPG
A qerf fo tnemtaert eht ni desu eb nac A niropsolcyC ro gnispaler-yltneulaminim ot eud emordnys citorhpen tnedneped-diorets .)47 gp( esaesid egnahc
bI leveL ,A edarG
B 5 ot pu fo esod a ta detrats eb nac A niropsolcyC tnemtaert eht ni yad/gk/gmorhpen tnedneped-diorets ro gnispaler-yltneuqerf fo ot eud emordnys cit
mda eb dluohs A niropsolcyC .esaesid egnahc laminim sesod eseht ta deretsini
15 51
yC .derepat eb dluohs sesod hcihw retfa raey 1 rof eb dluohs A niropsolc .)47 gp( sraey 3 retfa deunitnocsid
III leveL ,B edarG
B htiw rehtegot deretsinimda eb dluohs A niropsolcyC rof sdioretsocitroc nahc laminim ot eud emordnys citorhpen fo tnemtaert .)57 gp( esaesid eg
III leveL ,B edarG
B fo tnemtaert rof ypareht A niropsolcyc no stneitaP eud emordnys citorhpen vv inom cidoirep eah dluohs esaesid egnahc laminim ot .noitcnuf laner fo gnirot
a retfa deredisnoc eb dluohs yspoib laner taeper A A niropsolcyc fo raeyotorhpen fo ecnedive lacigolotsih tceted ot ypareht .)57 gp( yticix
III leveL ,B edarG
B fo tnemtaert rof desu eb nac litefom etalonehpocyM ro gnispaler-yltneuqerf laminim ot eud emordnys citorhpen tnedneped-diorets .)67 gp( esaesid egnahc
III leveL ,B edarG
B fom etalonehpocym ,A niropsolcyc ,edimahpsohpolcyC sumilorcat ro liten tnatsiser-diorets fo tnemtaert eht ni desu eb nac ot eud emordnys citorhpe
.)67 gp( esaesid egnahc laminim III leveL ,B edarG
sisorelcsoluremolG latnemgeS dna lacoF
B dna lacof ot eud emordnys citorhpen htiw stneitaP latnemgespusonummi htiw detaert eb dluohs sisorelcsoluremolg ecudni ot sa os noisserp
airunietorp fo noissimer .)97 gp( bII leveL ,B edarG
B dna lacof ot eud emordnys citorhpen htiw stneitaP latnemges sdiorets htiw detaert eb dluohs sisorelcsoluremolg .)97 gp(
III leveL ,B edarG
B dna lacof ot eud emordnys citorhpen htiw stneitaP latnemgessinderp esod hgih eviecer dluohs sisorelcsoluremolg sa yad/gk/gm 1 ta enolo
H itnoc eb dluohs sdiorets esod hgi .ypareht laitini retfa skeew 2 ot 1 rof deun8 gp( ylwols derepat neht dna deveihca si noissimer .)0
III leveL ,B edarG
16 61
B stneitap rof sdiorets htiw noitarud tnemtaert latoT emordnys citorhpen htiw luohs sisorelcsoluremolg latnemges dna lacof ot eud shtnom 6 tsael ta rof eb d
.)08 gp( III leveL ,B edarG
B dna lacof ot eud emordnys citorhpen htiw stneitaP latnemges-evitanretla htiw detaert eb yam sisorelcsoluremolg esiminim ot sdiorets yad
.)18 gp( yticixot dioretsocitroc bII leveL ,B edarG
B emordnys citorhpen fo noissimer eveihca ot eruliaF dna lacof ot eudtini retfa shtnom 6 yb sisorelcsoluremolg latnemges dioretsocitroc fo noitai
.)18 gp( ecnatsiser diorets sa denifed si yparehtIII leveL ,B edarG
B snoc eb nac edimahpsohpolcyc htiw ypareht cixototyC stneitap rof derediof ot eud emordnys citorhpen tnedneped-diorets htiw latnemges dna lac
is detaler-diorets htiw esoht ro sisorelcsoluremolg .)28 gp( stceffe ed III leveL ,B edarG
B snoc eb nac edimahpsohpolcyc htiw ypareht cixototyC evitanretla sa dereditorhpen tnatsiser-diorets htiw stneitap rof ypareht dna lacof ot eud emordnys ci
.)28 gp( sisorelcsoluremolg latnemges III leveL ,B edarG
B ennalp si ypareht edimahpsohpolcyc mohw ni stneitaP demrofni eb dluohs d stneitap elam ;ytilirets rof ksir laitnetop eht fo egarots mreps desivda eb dluohs
.)38 gp( III leveL ,B edarG
B tiw stneitap rof deredisnoc eb dluohs A niropsolcyC tnedneped-diorets hemolg latnemges dna lacof ot eud emordnys citorhpen esoht ro sisorelcsolur
mer gnitsal a sA .stceffe edis detaler-diorets htiw ,deveihca eb ton yam noissioissimer niatniam ot yrassecen eb yam esu mret-gnol .)38 gp( n
III leveL ,B edarG
A yad/gk/gm 5 ot 3 fo sesod gnitrats ta A niropsolcyC deredisnoc eb dluohs rdnys citorhpen tnatsiser-diorets htiw stneitap rof dna lacof ot eud emooissimer gnitsal a sA .sisorelcsoluremolg latnemges �deveihca eb ton yam n
oissimer niatniam ot yrassecen eb yam esu mret-gnol .)48 gp( n bI leveL ,A edarG
17 71
B htiw rehtegot deretsinimda eb dluohs A niropsolcyC stneitap rof sdioretsof ot eud emordnys citorhpen tnatsiser-diorets htiw latnemges dna lac
etS .deveihca si noissimer litnu sisorelcsoluremolg derepat eb yam sesod dior.)48 gp( yltneuqesbus
III leveL ,B edarG
B n fo tnemtaert rof A niropsolcyc gniviecer stneitaP ot eud emordnys citorhpe evah dluohs sisorelcsoluremolg latnemges dna lacof derotinom noitcnuf laner
.)58 gp( III leveL ,B edarG
A emordnys citorhpen evisnopser-diorets htiw stneitaP dna lacof ot eud of deredisnoc era ohw ,sisorelcsoluremolg latnemges yam ,ypareht evitanretla r
hpsohpolcyc ro A niropsolcyc rehtie htiw detaert eb .)58 gp( edimabI leveL ,A edarG
B emordnys citorhpen tnatsiser-diorets htiw stneitaP dna lacof ot eudert yllaitnereferp era sisorelcsoluremolg latnemges A niropsolcyc htiw deta
.)58 gp(III leveL ,B edarG
B tnemtaert eht ni desu eb yam litefom etalonehpocyM emordnys citorhpen fo8 gp( sisorelcsoluremolg latnemges dna lacof ot eud .)6
II leveL ,B edarG
B rt ni ypareht evitanretla sa desu eb yam sumilorcaT citorhpen fo tnemtaeorelcsoluremolg latnemges dna lacof ot eud emordnys .)68 gp( sis
III leveL ,B edarG
C i ypareht evitanretla sa desu eb yam siserehpamsalP citorhpen fo tnemtaert norelcsoluremolg latnemges dna lacof ot eud emordnys .)78 gp( sis
VI leveL ,C edarG
yhtaporhpeN AgI
C tiw stneitap rof dednemmocer si ypareht cificeps oN dna yhtaporhpen AgI h.)98 gp( airunietorp tuohtiw airutameah detalosi
VI leveL ,C edarG
18 81
C rutameah detalosi dna yhtaporhpen AgI htiw stneitaP derotinom eb dluohs aio tnempoleved eht rof )shtnom 21-3 yreve( ylraluger laner ,noisnetrepyh f
.)98 gp( airunietorp dna tnemriapmi VI leveL ,C edarG
C tiw stneitap rof dednemmocer si ypareht cificeps oN dna yhtaporhpen AgI hd/g 51.0 fo airunietorp dna airutameah citamotpmysa rehto on dna yad/g 1 ot ya
srotacidni lacigolotsih ro lacinilc esrevda .)09 gp( VI leveL ,C edarG
C rp dna airutameah dna yhtaporhpen AgI htiw stneitaP eb dluohs airunietovel eht rof )shtnom 21-3 yreve( ylraluger derotinom eht dna airunietorp fo lep( tnemriapmi laner dna noisnetrepyh fo tnempoleved .)09 g
VI leveL ,C edarG
A > airunietorp dna yhtaporhpen AgI htiw stneitaP detaert eb dluohs yad/g 1af laner fo noissergorp fo ksir eht ecuder ot sa os .)09 gp( eruli
bI leveL ,A edarG
B si ypareht rotibihni emyzne gnitrevnoc nisnetoignA rof dednemmocerhpen AgI htiw stneitap ni noisnetrepyh fo tnemtaert .)19 gp( yhtapor
aII leveL ,B edarG
A si ypareht rotibihni emyzne gnitrevnoc nisnetoignA ni dednemmocertorp dna yhtaporhpen AgI htiw stneitap evisnetomron > airunie .)19 gp( yad/g 1
bI leveL ,A edarG
A tla sa desu eb nac srekcolb rotpecer II nisnetoignA nisnetoigna ot sevitanren AgI htiw stneitap ni srotibihni emyzne gnitrevnoc ralimis rof yhtaporhpe
.)29 gp( snoitacidni bI leveL ,A edarG
A toigna dna srotibihni emyzne gnitrevnoc nisnetoignA rotpecer II nisneetorp ecuder ot noitanibmoc ni desu eb nac srekcolb AgI htiw stneitap ni airuni
> airunietorp dna yhtaporhpen .)29 gp( yad/g 1 bI leveL ,A edarG
A reht noitanibmoc nirafraw esod-wol dna elomadirypiD dednemmocer si ypa> airunietorp dna yhtaporhpen AgI htiw stneitap ni ton si esu stI .yad/g 1
nuf laner lamronba htiw stneitap ni detacidniartnoc .)39 gp( noitc bI leveL ,A edarG
19 91
B iw stneitap ni desu eb nac noitatnemelppus lio hsiF dna yhtaporhpen AgI ht.)49 gp( yad/g 3> airunietorp
III leveL ,B edarG
A tceles ni tnemtaert rof desu eb nac sdioretsocitroC AgI htiw stneitap de .)49 gp( yhtaporhpen
aI leveL ,A edarG
PPG a yticixot fo ksir tuohtiw ton si noisserppusonummI eb ylno dluohs dn airunietorp tnetsisrep htiw stneitap ni deredisnoc > htiw esoht ni ro yad/g 1qqvv aueda etipsed egamad laner evissergorp fo ecnedie lortnoc erusserp doolb et
59 gp( BRA ro IECA na htiw rewol ro gH mm 08/031 ta .)PPG
B eud emordnys citorhpen htiw stneitap rof tnemtaerT yhtaporhpen AgI ot)69 gp( yspoib laner no sgnidnif no desab eb dluohs .
aII leveL ,B edarG
B ih dlim dna yhtaporhpen AgI htiw stneitap citorhpeN no segnahc lacigolotsta enolosinderp htiw detaert eb dluohs yspoib laner 1 fo esod laitini na skeew 6-4 retfa gnirepat tneuqesbus htiw yad/gk/gm tnemtaert latot a rof
.)69 gp( shtnom 4-3 fo doirep aII leveL ,B edarG
B ih dlim dna yhtaporhpen AgI htiw stneitap citorhpeN ohw segnahc lacigolotsdneped diorets ro ecnatsiser diorets ,sespaler evah htiw detaert eb dluohs ecne
rof yad/gk/gm 0.2-5.1 fo esod a ta edimahpsohpolcyc htiw rehtegot shtnom 3-2 .)79 gp( enolosinderp esod-wol
aII leveL ,B edarG
C nac yad/gk/gm 5 fo esod laitini na ta A niropsolcyC citorhpen ni desu eb iaf ohw segnahc lacigolotsih dlim htiw stneitap AgI dna diorets l
tnemtaert dednemmocer ehT .ypareht edimahpsohpolcyc shtnom 21-6 si doirep atimocnoc nevig eb dluohs enolosinderp esod-wol dna .)79 gp( yltn
VI leveL ,C edarG
C ht segnahc lacigolotsih htiw stneitap AgI citorhpeN eb nac dlim ton era talcyc ro edimahpsohpolcyc ,enolosinderp htiw detaert esoht ot ralimis ,A niropso
.)79 gp( segnahc lacigolotsih dlim htiw VI leveL ,C edarG
20 02
PPG af ssel si ypareht evisserppusonummi ot esnopser sA ni elbaruovotsih ereves erom dna yhtaporhpen AgI htiw stneitap -revo ,segnahc lacigol
ednopser-non ni dediova eb dluohs noisserppusonummi .)89 gp( sr PPG
C uliaf laner etuca dna yhtaporhpen AgI htiw stneitaP laner ogrednu dluohs er.)89 gp( tnemtaert enimreted ot yspoib
VI leveL ,C edarG
C retnecserc ot eud eruliaf laner etuca htiw stneitaP dluohs yhtaporhpen AgI ciemolg ciretnecserc fo smrof rehto rof sa detaert eb T tnemtaer .sitirhpenolur
yb dewollof eb dluohs eslup enolosinderplyhtem htiw ,enolosinderp laro )89 gp( nirafraw dna elomadirypid ,edimahpsohpolcyc .
VI leveL ,C edarG
PPG nac snilubolgonummi suonevartni dna egnahcxe amsalP ni detutitsni eb gp( yhtaporhpen AgI ciretnecserc htiw stneitap emos .)99
PPG
C w stneitap rof dednemmocer si tnemtaert cificeps oN yhtaporhpen AgI htiolg dlim fo ecneserp eht ni eruliaf laner etuca dna laner no segnahc ralurem
.)99 gp( yspoib VI leveL ,C edarG
21
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