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=M D=GG #FJ= !@@ IHG AC HF=G ..................................................................................... 5

DFI FH=G................................................................................................................................................................. 7

H=H-HF F.......................................................................................................................................................... 8

M F=F=H=G F =@HH=................................................................................................................................ 9

#JGH=H=G F F= =M =GG ............................................................................................................................. 9

C@GG=TH= F= =M =GG ................................................................................................................................. 10

@ 1 C@GG=TH= F= =M =GG IG= ! AC HF=G................................................... 11

FIM =HF=............................................................................................................................................................... 12

@ 2 FIM =HF= ! (IF H=G F MF, M ! AC HFM) F

@ K=H, F H F=G , CD .................................................................................................................................................... 13

1 H=G ..........................................................................................................................................................15

FG IG = H=G I=@= ......................................................................................................................................................... 15

1.1 #JGH=H=G F F= =M =GG ....................................................................................................................... 16

1.2 C@GG=TH= F= =M =GG .......................................................................................................................... 21

1.3 FIM =HF= ....................................................................................................................................................... 23

1.4 #FH= IH= ................................................................................................................................................... 27

1.5 FF@ F=HF= ......................................................................................................................................................................... 29

1.6 FHFM..................................................................................................................................................................... 30

1.7 HF @=H=G ................................................................................................................................................................ 33

2 #@HH=: HH= GHFH ...............................................................................................................................35

2.1 C@I@H= GH=HG FH==-G @FI@F T@HFH= FH (!) .................................................... 35

2.2 G= MGHH= C-G GH=HG ! ....................................................................................................................... 36

2.3 C@GG=M= F= =M =GG .................................................................................................................................... 37

2.4 IFHF FGIFG..................................................................................................................................................................... 38

3 GF FH=G .......................................................................................................................................39

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3.1 @-H...................................................................................................................................................................... 39

3.2 AH=@H@H HFM ................................................................................................................................................................ 39

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3.4 F= =-@KF= HG...................................................................................................................................................... 40

3.5 =H= D GI@HG = H H CDR=F@ =GFFG ....................................... 40

4 HF =FH=...........................................................................................................................................................42

4.1 K H=G I=@= KG J@................................................................................................................ 42

4.2 @H #CE I=........................................................................................................................................................... 42

5 !I=@= DJ@H !FI, H=@ C@@FH= CHF #CE FH H..........45

5.1 !I=@= DJ@H !FI ........................................................................................................................................... 45

5.2 H=@ C@==@ !I=@= CHF ................................................................................................................................... 46

5.3 #CE FH H.................................................................................................................................................................... 46

CG HF I@=H=................................................................................................................................................48

AIH H=G I=@= ...........................................................................................................................................................49

H =FH=......................................................................................................................................................................... 49

HFH FH=G.................................................................................................................................................... 60

HF JFG=G H=G I=@= ................................................................................................................................................. 61

#@HH= ................................................................................................................................................................................ 61

IF FGG==@=HM........................................................................................................................................................................... 61

CMF=H............................................................................................................................................................................................. 62



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=G I=@= F@G C!73.

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=G H J GH.

@GG=TH= CD G J@J JF H=. # 2004, H DFHH "@H'G H=@

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F@=H=G HH M == =GHFM =M HFG@HH=.

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http://www.nice.org.uk/guidance/cg182/chapter/about-this-guidelinehttps://www.gov.uk/government/publications/national-service-framework-kidney-diseasehttps://www.gov.uk/government/publications/national-service-framework-kidney-diseasehttp://www.kidney.org/professionals/kdoqi/http://www.kidney.org/professionals/kdoqi/http://www.kidney.org/professionals/kdoqi/http://www.kidney.org/professionals/kdoqi/https://www.gov.uk/government/publications/national-service-framework-kidney-diseasehttps://www.gov.uk/government/publications/national-service-framework-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/about-this-guideline

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2), H =H= H GITL '' H H

G==TH FH=IF= H M GH. 2008 #CE I=@= T G==TH FH=IF= G

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FH=:FH== FH= 50 /@ F =F). # 2013, H =M D=GG: #FJ= !@@

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H H GI=J=G= ! HF=G GIGH M H #CE I=@=, IH @G =@I 3

AC HF=G (AC IF 3 /@, 3R30 /@, JF 30 /@) F !

HFM = IH @GG=TH= (G GK = H @@K= H@G).

=G IH H #CE I=@= FJ=KG H @GG=TH= CD.

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!1 >90 F@ F =

!2 60R89 =@@M FG*

!3 45R59 =@@M H FH@M FG

!3 30R44 FH@M H GJF@M FG

!4 15R29 JF@M FG

!5

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* @H=J H MI I@H @J@

** #@I= FH= GMF (AC IGI@@M >220 /@)

AFJ=H=G: AC, @I=:FH== FH=; CD, F= =M =GG

F=H K=H F=GG= F =M D=GG: #FJ= !@@ IHG (D#!) CD

F !FI (2013) D#! 2012 @==@ FH= I=@= F H J@IH=

H F= =M =GG. =M #HFH=@ (I@. 3): 1R150

&H FGHH= @ K=H =M =@IF =FGG F==HM, FH@=HM GG=H

@HF GHG. D=G=G @ K=H =M =GG G =FJ G= H =HFIH=

H=@ GH=H ! FFH= CD ==HFG = H F=FM F I@=HM IHG

FKF, @G IG HF =G =FG I@= @H FGG=@ KFGG CD.

"KJF, @H FGHH= KG GH=@@ FFH G 19% JF@@ = H @ AGG=H='G 2013@ =GHFM FFH.

HH@ GH CD = E@ = 2009R10 KG GH=H H HK O1.44 O1.45 =@@=,

K= KG FL=H@M 1.3% @@ " G= = HH MF1

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GH F@ F@H HFM F H 2% @ K=H CD HH FFGGG H =M

=@IF. #H KG GH=H = H = @ HH FL=H@M 7000 LGG GHFG 12,000

LGG MF=@ =FH=G IFF = @ K=H CD = 2009R10 (F@H=J H -

F-H I@H= K=HIH CD), K=H GH=H GH HK O174 O178 =@@=. HFH=G = H F@=F =H=TH= FJH= FFGG= H -GH

=M =GG F @F@M .

=G I=@= GG H FGG HG =GGIG M IH= H 2008 #CE I= = FG KF

K H J J=@@, FJ== K I= = FG KF FJ=IG@M

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@GG=TH= CD =H=TH= @ H F=G CD @=H=G FFGG=

H T=H= CD FFGG=

H F@H=G= HK IH =M =IFM CD

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FHFM F CD.

D' %#/%$!/

I=@= K=@@ GGI HH FGF=FG K=@@ IG FI'G GIFM FIH FHF=GH=G H=F =G=G K=H ==J=I@ H=HG.

1FF , BFM B, @ $ H @. (2012) EGH=H= H T=@ GH F= =M =GG H

H " = E@. F@M D=@MG=G FG@HH=. 27 (I@. 3): ===73R80


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H=H-HF FH=H-HF F

=G I=@= FG GH FH= J= H F I@HG K=H F= =M =GG.

H=HG @HF FGG=@G J F=HG FGG==@=H=G G GH IH = H "

CGH=HIH= F E@ R @@ #CE I= =G KF=HH H FUH HG. FHH F GI@

H =H IH ==J=I@ G FFG. H=HG GI@ J H FHI=HM H

=F =G=G IH H=F F HFHH, = FHFG= K=H H=F @HF

FGG=@G. "@HF FGG=@G GI@ @@K H DFHH "@H'G J=

GH. # G G H J =HM H =G=G, @HF FGG=@G GI@

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FH= F=JH= @=FHM GIFG.

#CE G FI I= H HG H=H LF= = I@H " GFJ=G.

A@@ @HF FGG=@G GI@ @@K H FH=G = H=H LF= = I@H "

GFJ=G.


https://www.gov.uk/government/publications/the-nhs-constitution-for-englandhttps://www.gov.uk/government/publications/the-nhs-constitution-for-englandhttps://www.gov.uk/government/publications/reference-guide-to-consent-for-examination-or-treatment-second-editionhttps://www.gov.uk/government/publications/reference-guide-to-consent-for-examination-or-treatment-second-editionhttp://www.justice.gov.uk/protecting-the-vulnerable/mental-capacity-acthttp://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085476http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085476http://www.nice.org.uk/guidance/cg138http://www.nice.org.uk/guidance/cg138http://www.nice.org.uk/guidance/cg138http://www.nice.org.uk/guidance/cg138http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085476http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085476http://www.justice.gov.uk/protecting-the-vulnerable/mental-capacity-acthttps://www.gov.uk/government/publications/reference-guide-to-consent-for-examination-or-treatment-second-editionhttps://www.gov.uk/government/publications/reference-guide-to-consent-for-examination-or-treatment-second-editionhttps://www.gov.uk/government/publications/the-nhs-constitution-for-englandhttps://www.gov.uk/government/publications/the-nhs-constitution-for-england

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M F=F=H=G F =@HH=M F=F=H=G F =@HH=

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FH=G =G = GH= 1.

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IG H CF= =M D=GG E==@M C@@FH= (CD-E#) FH==

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H GHF=G FF HF=@

IG FH== GGMG HH F G=T (F L@, NMH= GGMG) NF-=G

F K=H =GH =@IH= GG GHFHFM (#D)

FH==H = H=@ LHF@ I@=HM GGGGH G F FH==. KK

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CG=F IG= !MGHH=C H ==H=@ =G=G H TF F FI@ IH CD = @ K=H:

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FH=IF= (@I=:FH== FH= AC @GG H 3 /@) F HF FF

=M =GG. K 2014K 2014

D H =G CD = @ K=H:

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HF FF =M =GG. K 2014K 2014

F HGH= F CD IG= !FH== AC H @ K=H M H @@K= F=G

HFG:

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IH =M =IFM (G FH= 1.3.9)


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F=JGI@F =GG (=G= FH =GG, F= FH =@IF, F=F@

JGI@F =GG F FF@ JGI@F =GG)

GHFIHIF@ F@ HFH =GG, FIFFH F@ @I@= F FGHH= MFHFM

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FG ! =G GG=H K=H =FG F=G JFG IHG

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H=GHG, A#DG =IFH=G)

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KHF HM J G GFJH=J H CD. K 2014K 2014


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11 H=GH=G

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H @GH 2 G=G GFH M

F= H @GH 90 MG (K=H F K=HIH FFG =M ).

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CD =G @GG=T F= H GH=H ! (!) @I=:FH== FH= (AC) (G H@1), IG= '!' H H H ! HFM (!1R!5, K= J H G ! HFG@G G H CD

GHG 1R5 F FJ=IG@M) 'A' F H AC HFM (A1RA3), F L@:

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AC 15 /@ G CD !4A2.

A FG K=H ! 50 @/=/1.73 2

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!: =HF GIF F GH=H !

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!FH==: GH=H= ! IG= GFI FH==

!MGHH=C: GH=H= ! IG= MGHH= C.


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F K=H =GH =@IH= GG GHFHFM (#D)

FH==H = H=@ LHF@ I@=HM GGGGH G F FH==. KK

20142014



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F F =FH= IH =@H= H=G FH=, G =@HH=:

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20082008

1.1.5 AJ=G @ H H H M H = H 12 IFG F J= @ HGH F

!FH==. AJ= @M= H GH @ G@G H GIF HH

HM F F=J FGG M H @FHFM K=H= 12 IFG

JIHIF. 20082008

C8! CC8! C-"!%$ %!% /& GFR-"!%$ %!% /& GFR

1.1.6 JF FIGH F GFI MGHH= C GIFH =G , @==@

@FHF=G GI@ FFH GH=H @FI@F T@HFH= FH

(!MGHH=C) IG= F=H= IH= (G FH= 1.1.7) =

=H= H FFH= H GFI MGHH= C FGI@H. K 2014K 2014

1.1.7 =FJ GGGGH F=G =G (G FH= 1.1.14),

@==@ @FHF=G GI@ IG H CD-E# MGHH= C IH= H GH=H

!MGHH=C. K 2014K 2014

1.1.8 C@==@ @FHF=G GI@ IG MGHH= C GGMG @=FH H H =HFH=@GHF H GIF GFI MGHH= C F MGHH= C-G GH=HG !.

K 2014K 2014

1.1.9 #HFFH !MGHH=C K=H IH= = @ K=H IHF@@ HMF=

=GG IG !MGHH=C J@IG M @G@M @JH = @ K=H

MHMF==G FI = @ K=H MFHMF==G. K 2014K 2014


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R%0/' !$ %0R%0/' !$ %0%' GFR %' GFR !%!%

1.1.10 C@==@ @FHF=G GI@ FFH ! =HF G K@ IF = =H =G 90 @/

=/1.73 2

F @GG, F G 'FHF H 90 @/=/1.73 2'. K 2014K 2014

1.1.11 # ! =G FHF H 90 @/=/1.73 2, IG =FG = GFI FH==

HFH= F H 20% H =F G==TH FIH= = =M

IH=. K 2014K 2014

1.1.12 #HFFH ! J@IG 60 @/=/1.73 2

F F K=H IH=, F= =

= HH GH=HG ! @GG IFH G H HFI ! =FGG.

20142014

1.1.13 CTF ! FGI@H @GG H 60 @/=/1.73 2

= FG H

FJ=IG@M HGH M FH= H HGH K=H= 2 KG. A@@K F =@=@

@MH=@ JF==@=HM GFI FH== (Q5%) K =HFFH= G =

!. 20082008

W% / % ! #8! CW% / % ! #8! C-"!%$ %!% /& GFR &/ $!'/ /& CKD-"!%$ %!% /& GFR &/ $!'/ /& CKD

1.1.14 CG=F IG= !MGHH=C H ==H=@ =G=G H TF F FI@ IH CD =

@ K=H:

!FH== 45R59 @/=/1.73 2, GIGH= F H @GH 90 MG

FH=IF= (@I=:FH== FH= AC @GG H 3 /@) F HF FF

=M =GG. K 2014K 2014

F =FH= IH =@H= H=G FH=, G =@HH=:

HH= GHFH.

1.1.15 D H =G CD = @ K=H:

!FH== 45R59 @/=/1.73 2

!MGHH=C F H 60 @/=/1.73 2

HF FF =M =GG. K 2014K 2014


http://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-diseasehttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#markers-of-kidney-disease

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W% '8 !##W% '8 !##!% %!!% %!% /& GFR !% /& GFR !% % %%%$%$

1.1.16 F =@M IFH GIF ! =G FI=F R F L@, IF=

=HF= HFM = H J@IH= F@ IH= = HH=@

@=J= FG R G=F FF GHF GIF (=I@=, 51CF-EDA,125

#-=H@H F =L@). 20082008

FH=IF=FH=IF=

1.1.17 D H IG FH GHF=G H =H=M FH=IF= I@GG HM F @

G=T@@M GIF= @I= H @K HFH=G LFGG= H FGI@H

G AC. 20082008

1.1.18 HH =H=M FH=IF=, IG IF= AC = FF H

FH=:FH== FH= (C), IG =H G FHF GG=H=J=HM H C F

@K @J@G FH=IF=. F IH=TH= =HF= @J@G

FH=IF= AC 70 /@ F F, C IG G @HFH=J.

AC =G H F H F @ K=H =HG. 2008, 2008,

20142014

1.1.19 F H ==H=@ HH= FH=IF=, = H AC =G HK 3 /@

70 /@, H=G GI@ TF M GIGIH F@M F= G@. #

H ==H=@ AC =G 70 /@ F F, FH G@ H HGH.

2008, 20142008, 2014

1.1.20 F TF AC 3 /@ F F G @==@@M =FHH

FH=IF=. 2008, 20142008, 2014

1.1.21 IH=M IF=FM @I= F IF=FM FH= @GG G = FH= 1.1.18

F:

@ K=H =HG

@ K=HIH =HG K=H ! @GG H 60 @/=/1.73 2. 2008, 2008,

20142014

1.1.22 IH=M M @FHFM HGH= H IF=FM @I= F IF=FM FH= @GG

@ K=H ! 60 @/=/1.73 2

F F = HF =G GHF GIG==

CD (G @G FH= 1.1.28). 20082008



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"HIF="HIF=

1.1.23 HGH= F H FG HIF=, IG FH GHF=G FHF H

IF= =FGM.

EJ@IH IFHF = HF =G FGI@H 1+ F F.

D H IG IF= =FGM H TF G=H=J FGI@H. 20082008

= =G@H == =G@H =J=G=@ HIF=J=G=@ HIF=

1.1.24 HF =G H H =FH=H FG=GHH =J=G=@ HIF= = H

G FH=IF= F HFG=H HIF=, FF 2 IH 3 G=H=J

FH GHF= HGHG G TFH= FG=GHH =J=G=@ HIF=. 20082008

1.1.25 FG=GHH =J=G=@ HIF=, K=H F K=HIH FH=IF=, GI@ FH

=JGH=H= F IF=FM HFH @=M = FF=H FIG. 20082008

1.1.26 FG=GHH =J=G=@ HIF= = H G FH=IF= GI@ @@K

I I@@M K=H FH HGH= F HIF= (G FH=G 1.1.24

1.1.25), FH=IF= F @I=IF=, ! @ FGGIF =HF= G

@ G H HIF= FG=GHG. 20082008

GI@ HGH F CD GI@ HGH F CD

1.1.27 =HF ! H @GH I@@M = @ FGF= FIG K H

FHL=, GI G @=IF= ===HFG (F L@, M@GF= F

HF@=IG), @=H=I -GHF=@ H=-=UHFM FIG (A#DG). 2008,2008,

2014 2014

1.1.28 F HGH= F CD IG= !FH== AC H @ K=H M H

@@K= F=G HFG:

=HG

MFHG=

IH =M =IFM (G FH= 1.3.9)

F=JGI@F =GG (=G= FH =GG, F= FH =@IF, F=F@JGI@F =GG F FF@ JGI@F =GG)


http://www.nice.org.uk/guidance/cg182/chapter/recommendations#acute-kidney-injury-and-ckdhttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#acute-kidney-injury-and-ckd

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GHFIHIF@ F@ HFH =GG, FIFFH F@ @I@= F FGHH= MFHFM

I@H=GMGH =GGG K=H HH=@ =M =J@JH R F L@, GMGH= @IIG

FMHHGIG

=@M =GHFM -GH =M =GG (! HFM !5) F F=HFM =M

=GG

FHI=GH= HH= HIF=. K 2014K 2014

1.1.29 D H IG , F F H==HM G F=G FFG H HGH @ F CD. #

H G H@= GMF, =HG F MFHG=, H IG

G=HM @ G F=G FF H HGH @ F CD. 2008, 20142008, 2014

1.2 C!:#!/ /& #/# +$%8 $%!%

1.2.1 C@GG=M CD IG= =H= ! AC HF=G (G GF= =

H@ 1). B KF HH:

=FG AC =G GG=H K=H =FG F=G JFG IHG

FG ! =G GG=H K=H =FG F=G JFG IHG

=FG AC FG ! = =H= I@H=@M H F=G JFG

IHG. K 2014K 2014

F =FH= IH =@H= H=G FH=, G =@HH=:

HH= GHFH.


http://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-startedhttp://www.nice.org.uk/guidance/cg182/chapter/implementation-getting-started

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@ 1 C@GG=TH= F= =@ 1 C@GG=TH= F= =M =GG IG= ! AM =GG IG= ! AC HF=GC HF=G

1.2.2 D H HF= H CD G@@M M . K 2014K 2014



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##JJGH=H= H IG CD HF== H F=G JGH=H= H IG CD HF== H F=G JFG IHGFG IHG

1.2.3 AF @ H GH@=G H IG CD IF= =F =GIGG= K=H

H FG K=H CD, FH=I@F@M = H IG M HFH@ (F L@,

IF=FM HFH GHFIH=, FHL= FIG F @FI@F =GG). K 2014K 2014

1.2.4 G H FG'G ! AC HF=G (G H@ 1) H ==H H=F F=G

JFG IHG (F L@, CD FFGG=, IH =M =IFM, @@-IG

FH@=HM F=JGI@F JHG) =GIGG H=G K=H H. K 2014K 2014

#=H=G F F@ I@HF#=H=G F F@ I@HFGIGI

1.2.5 F F@ I@HFGI G H @@ @ K=H CD K:

J @FH FFGG= CD (G FH= 1.3.3)

J J=G=@ F FG=GHH =J=G=@ HIF=

J GMHG IF=FM HFH GHFIH=

J =@M =GHFM @MMGH= =M =GG F JF 20 MFG

J ! @GG H 30 @/=/1.73 2

(! HFM !4 F !5)

F G=F M F@=GH H FI=F F@ =GM. 2008, 20142008, 2014

1.2.6 AJ=G @ K=H =@M =GHFM =F=H =M =GG IH H

=@=H=G F@ FGI@H F F@ I@HFGI G =G FF F

H. 20082008

1.3 F%%#8 /& //'

1.3.1 AF H FIM =HF= (!FH== AC) K=H H FG

K=H, F H F=G , CD; F = = HH CD =G H FFGG=J = M @.

K 2014K 2014

1.3.2 G H@ 2 H I= H FIM ! =HF= F @ K=H, F H F=G

, CD, IH H=@F =H H H FG F= H:

H IF@M= IG CD



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GH HHFG ! AC (IH KF HH CD FFGG= =G H -

@=F)

F==H=G, G=@@M FH =@IF

G H H=F HFHH (GI G F=R=HG=R@GHF GMGH AA

H=GHG, A#DG =IFH=G)

=HFIFFH =@@GG

KHF HM J G GFJH=J H CD. K 2014K 2014


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@ 2 @ 2 FIM =HF= ! (IF H=G F MFIM =HF= ! (IF H=G F MFF, , M ! AM ! ACC

HFM) F @ K=H, F H F=G HFM) F @ K=H, F H F=G , CD, CD



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DT= FFGG=DT= FFGG=

1.3.3 DT @FH FFGG= CD G:

GIGH= FG = ! 25% F F = ! HFM K=H=12 HG FF

GIGH= FG = ! 15 @/=/1.73 2

F MF. K 2014K 2014

1.3.4 H @@K= GHG H =H=M H FH FFGG= CD:

H= ==I 3 ! GH=H=G JF F= H @GG H 90 MG.

# @ K=H K T= FI !, FH H ! K=H= 2 KG H L@IIGG IH HF=FH= ! R F L@, IH =M =IFM F GHFH=

F=R=HG= GMGH H=GH HFM. 2008, 20142008, 2014

1.3.5 B KF HH @ K=H CD F H =FG F=G FFGG= H -

GH =M =GG = HM J =HF H @@K=:

GIGH= FG = ! 25% F F JF 12 HG FF

GIGH= FG = ! 15 @/=/1.73 2

F F JF 12 HG. 2008,2008, 2014 2014

1.3.6 GGGG= CD FFGG=, LHF@H H IFFH FH @=

! H H=G =H IH K @= =HFJH= GHFH=G,

FH=I@F@M = =H GIGHG HH H FG =H F@ F@H HFM

= H=F @=H=. 2008, 20142008, 2014

=G HFG GG=H K=H CD FFGG==G HFG GG=H K=H CD FFGG=

1.3.7 F K=H @ K J M H @@K= F=G HFG F CD

FFGG= H H==G H=F @H:

F=JGI@F =GG

FH=IF=

IH =M =IFM

MFHG=


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=HG

G=

AF=, AF=-CF= F AG= =@M F==

F= IG A#DG

IHFH IF=FM IHUK HFH GHFIH=. K 2014K 2014

1.3.8 # @ K=H CD H F= IG A#DG M GG=H K=H

FFGG= IH IG =G GG=H K=H FJFG=@ FG = !.

ELF=G IH= K HFH= @ K=H CD K=H A#DG JF F@

F=G H=. =HF H HG !, FH=I@F@M = @ K=H @K

G@= ! /F = H FG HF F=GG F FFGG=. 20082008

AIH =AIH =M =IFM CDM =IFM CD

1.3.9 =HF @ F H J@H F FFGG= CD F H @GH

2R3 MFG HF IH =M =IFM, J = GFI FH== G FHIF H

G@=. K 2014K 2014

1.3.10 AJ=G @ K J IH =M =IFM HH HM F H =FG F=G CD J@= F FFGG=. K 2014K 2014

1.4 I&/!/ !$ %$#!/

1.4.1 F @ K=H CD IH= =FH= H=@F H H GJF=HM

IG CD, H GG=H @=H=G H F=G FFGG=. 20082008

1.4.2 J@= =FH= F IH= FFG, =J@J @ K=HCD = H=F J@H F H IHGH. @@K= H=G F GIGH.

H =G CD K G =H H @?

H IGH=G GI@ @ G IH H=F =MG?

H HFHHG F J=@@ F CD, KH F H=F JHG =GJHG

KH @=H=G F G= HG M IF G FGI@H HFHH/=H=?

H @ H =UI H=F K =H=?



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# KH KMG I@ CD =HG HFHH H @'G =@M @=, G=@ H=J=H=G,

KF FHI=H=G T=@ G=HIH=, =@I= THG @@KG J=@@?

"K @ K=H IGH H CD KH GIFG GM@=@

GIFH F J=@@?

FF=H, F =FH= IH F@ F@H HFM (GI G H

FIM @H H= =@MG=G HFHH GGG=G F LG F-

H=J HFG@HH=) H FFH= FI=F (GI G J= TGHI@ F

F=H@ HHF).

CGFJH=J H K =H M G=F. 20082008

1.4.3F @ K=H CD =-I@=HM =FH= F IH= FFG GFF=H H H GJF=HM H=F =H= H @@K H= F H H I@@M

IFGH =F =G IH H=F HFHH. 20082008

1.4.4 "@HF FGG=@G FJ== =FH= IH= FFG

GI@ GIF HM J G=@=GH K@ IH CD H GGFM

G=@@G H =@=HH @F=. 20082008

1.4.5 "@HF FGG=@G KF= K=H @ K=H CD GI@ H IH

H GM@=@ GHG = K=H H =H= F GG H

FF=H GIFH R F L@, GIFH FIG, IG@@= F G=@=GH

IFG. 20082008

&=GHM@ J=&=GHM@ J=

1.4.6 EIF @ K=H CD H H LF=G, =J @HM K=H GH

G=. 20082008

D%!8 %D%!8 %%/%/

1.4.7 F =HFM J= IH HGG=I, GH, @F= G@H =H

FF=H H H GJF=HM CD. 2008, 20142008, 2014

1.4.8 F =HFM =HFJH= =G F H=G GI@ IF K=H= H HLH

IH=, H=@ =HFM GGGGH GIFJ=G= H GIF @IHF=H=

=G FJH. 20082008



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L/-0L/-0/% $%/% $%

1.4.9 D H F @K-FH= =HG (=HFM FH= =H @GG H 0.6R0.8 //

M) H @ K=H CD. K 2014K 2014

@-H@-H

1.4.10 EGIF HH GMGHG F = @ H:

=F @ K=H CD H=F =G=G

@ @ K=H CD H GF = =G=-= IH H=F F

GIFH G@-H (H=G =@IG FJ== =FH= IH @ FGGIF,G= GGH=, LF=G, =H ==G) @ @ H =F

=G. K 2014K 2014

1.4.11 !=J @ GG H H=F =@ H (=@I= =G=G, F==H=G, HGH

FGI@HG, HFHHG FFG) HFI =FH= GMGHG, GI G

@ H=H=K, H IF @ H H G@- H=F CD. KK

20142014

1.5 R%&%! #%!

1.5.1 =H IH H ==J=I@'G K=GG F==H=G K G=F=

FFF@. 20082008

1.5.2 @ K=H CD = H @@K= FIG GI@ F@@M FFF F

G=@=GH GGGGH:

! @GG H 30 @/=/1.73 2 (! HFM !4 F !5), K=H F K=HIH =HG

AC 70 /@ F F, I@GG K H IG M =HG @FM

FF=H@M HFH

AC 30 /@ F F (AC HFM A3), HHF K=H HIF=

GIGH= FG = ! 25% F F, = ! HFM F GIGH=

FG = ! 15 @/=/1.73 2

F F K=H= 12 HG


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MFHG= HH F=G F@M HF@@ G=H H IG H @GH 4

H=MFHG=J FIG H HFIH= GG (G @G "MFHG= #CE I=@=

C!127)

K F GIGH FF F H= IGG CD

GIGH F@ FHFM GHG=G. 2008, 20142008, 2014

1.5.3 CG=F =GIGG= H =GGIG K=H G=@=GH M @HHF, =@ F

H@ = GG KF =H M H GGFM F H FG K=H CD H

G M H G=@=GH. 20082008

1.5.4 FFF@ G @ =H@M F (HK H FG

K=H CD F H=F FF H @HF FGG=@), =H M GG=@ FFIH= @@K-I H H @ H H H=H'G ! GIFFM FHF H =

G=@=GH @==. # H=G =G H G, F=HF= F IHIF FFF@ F F-FFF@ GI@

G=T. 20082008

1.5.5 @ K=H CD F@ IHUK GHFIH= GI@ F@@M FFF H

IF@=@ GFJ=G, I@GG IFH =@ =HFJH= =G FI=F R F

L@, F H HFHH MF@=, GJF IF=, =G=G F UI=

JF@. 20082008

1.6 P!!#/%!08

B@ FGGIF HF@B@ FGGIF HF@

1.6.1 # @ K=H CD = H H GMGH@= @ FGGIF @K 140 "

(HFH F 120R139 ") H =GH@= @ FGGIF @K

90 "3

. 20082008

1.6.2 # @ K=H CD =HG, @G = @ K=H AC 70 /

@ F F, = H H GMGH@= @ FGGIF @K 130 " (HFH

F 120R129 ") H =GH@= @ FGGIF @K 80 "3

.

20082008

C= H=C= H=MFHG=JMFHG=J H H

1.6.3 F @K-GH F=R=HG= GMGH H=GH H @ K=H CD :


http://www.nice.org.uk/guidance/cg127http://www.nice.org.uk/guidance/cg182/chapter/recommendations#terms-used-in-this-guidelinehttp://www.nice.org.uk/guidance/cg182/chapter/recommendations#terms-used-in-this-guidelinehttp://www.nice.org.uk/guidance/cg127

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=HG AC 3 /@ F F (AC HFM A2 F A3)

MFHG= AC 30 /@ F F (AC HFM A3)

AC 70 /@ F F (=FFGH=J MFHG= F F=JGI@F

=GG)4

. K 2014K 2014

1.6.4 D H F =H= F=R=HG= GMGH H=GHG H @

K=H CD. K 2014K 2014

1.6.5 @@K H HFHH FH=G = "MFHG= (#CE I=@=

C!127) F @ K=H CD, MFHG= AC @GG H 30 /

@ (AC HF=G A1 A2), = HM H J =HG. K 2014K 2014

1.6.6 =FJ F, =F @ K F FGF= F=R=HG=

GMGH H=GHG IH H =FH :

=J= H H=@ H@FH G F=R=HG= GMGH H=GHG

=HF= ! GFI HGG=I = =J= H=G G@M. 20082008

1.6.7 # @ K=H CD, GIF GFI HGG=I HFH=G GH=H H

! F GHFH= F=R=HG= GMGH H=GHG. H HG

GIFHG HK 1 2 KG HF GHFH= F=R=HG= GMGH

H=GHG HF G =FG. 20082008

1.6.8 D H FIH=@M F F=R=HG= GMGH H=GH H @ K=H

CD = H=F FHFHH GFI HGG=I HFH= =G FHF H

5.0 @/@=HF. 2008, 20142008, 2014

1.6.9 MF@= F@IG IG F=R=HG= GMGH H=GHG,GGGGH, =JGH=H= HFHH HF HFG K H FH

MF@= GI@ IFH H GFI HGG=I HFH=

F. 20082008

1.6.10 CIFFH FGF=H= FIG K H FH MF@= =G H

HF==H= H H IG F=R=HG= GMGH H=GHG, IH

KF HH F FIH =HF= GFI HGG=I HFH= M

FI=F. 20082008


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1.6.11 H F=R=HG= GMGH H=GHG = H GFI HGG=I

HFH= =FGG H 6.0 @/@=HF F F HF FIG K H

FH MF@= J =GH=I. 20082008

1.6.12 @@K= H =HFIH= F G =FG F=R=HG= GMGH

H=GHG, H =M H G = =HF H ! FG F

FHFHH G@= =G @GG H 25% F H GFI FH== =FG F

G@= =G @GG H 30%. 20082008

1.6.13 # HF =G FG = ! F =FG = GFI FH== HF GHFH= F

=FG= H G F=R=HG= GMGH H=GHG, IH =H =G @GG H

25% (!) F 30% (GFI FH==) G@=, FH H HGH = 1R2 KG.

D H =M H F=R=HG= GMGH H=GH G = H =! =G @GG H 25% F H = GFI FH== =G @GG H 30%. 20082008

1.6.14 # H ! =G 25% F F, F H = GFI FH== =G 30% F

F:

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F=F GHF F HFG=H =G= HH

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@=HF=@ (1-25-=MFLM@@=F@) H @ K=H ! @GG H

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22 #@HH=: HH= GHFH#@HH=: HH= GHFH

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http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2http://egfrcalc.renal.org/http://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtmlhttp://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtmlhttp://mdrd.com/http://mdrd.com/http://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtmlhttp://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtmlhttp://egfrcalc.renal.org/http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2

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AGG=H= C@==@ B==GHFM &FHFM ==, & GHG @=

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http://www.labtestsonline.org.uk/understanding/analytes/gfr/tab/glance/http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2http://www.nice.org.uk/guidance/cg182/chapter/recommendations#investigations-for-chronic-kidney-disease-2http://www.labtestsonline.org.uk/understanding/analytes/gfr/tab/glance/

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C@===G F @=@M H K@ H =HFIH= F IFH HGH F ! IG

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IG AC ! = =H= K=@@ @@K HHF F=G GHFH=TH=.


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2.4 F% %/#%

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H H IH I=@= FH=G I@=HM GHF GIFG F J=@@ H

#CE KG=H.


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33 GF FH=GGF FH=G

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3.3 R%9!'/%9!$/%/% 8%

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44 HF =FH=HF =FH=

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http://www.nice.org.uk/Guidance/CG182/Documentshttp://www.nice.org.uk/guidance/cg182/chapter/the-guideline-development-group-national-collaborating-centre-and-nice-project-teamhttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/http://www.nice.org.uk/guidance/cg138http://www.nice.org.uk/guidance/cg76http://www.nice.org.uk/guidance/cg181http://www.nice.org.uk/guidance/cg180http://www.nice.org.uk/guidance/ta275http://www.nice.org.uk/guidance/ta275http://www.nice.org.uk/guidance/cg169http://www.nice.org.uk/guidance/cg157http://www.nice.org.uk/guidance/cg157http://www.nice.org.uk/guidance/cg169http://www.nice.org.uk/guidance/ta275http://www.nice.org.uk/guidance/ta275http://www.nice.org.uk/guidance/cg180http://www.nice.org.uk/guidance/cg181http://www.nice.org.uk/guidance/cg76http://www.nice.org.uk/guidance/cg138http://www.nice.org.uk/http://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/guidance/cg182/chapter/the-guideline-development-group-national-collaborating-centre-and-nice-project-teamhttp://www.nice.org.uk/Guidance/CG182/Documents

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!I= F K=H G=H@ =@MG=G F H=HG K=H -GH F@

=@IF (2002) #CE H@M F=G@ I= 48.

F F JJ@H@H

#CE =G J@= H @@K= I=. IFHF =FH= =G J=@@ H #CE KG=H.

FF@ F GIGH F (IH). #CE I=@=. I@=H= LH M 2015.


http://www.nice.org.uk/guidance/cg146http://www.nice.org.uk/guidance/ta261http://www.nice.org.uk/guidance/ta261http://www.nice.org.uk/guidance/ta256http://www.nice.org.uk/guidance/ta256http://www.nice.org.uk/guidance/ta249http://www.nice.org.uk/guidance/cg127http://www.nice.org.uk/guidance/cg125http://www.nice.org.uk/guidance/cg114http://www.nice.org.uk/guidance/cg108http://www.nice.org.uk/guidance/ph25http://www.nice.org.uk/guidance/cg91http://www.nice.org.uk/guidance/cg87http://www.nice.org.uk/guidance/ta164http://www.nice.org.uk/guidance/ta117http://www.nice.org.uk/guidance/ta117http://www.nice.org.uk/guidance/ph1http://www.nice.org.uk/guidance/cg15http://www.nice.org.uk/guidance/ta48http://www.nice.org.uk/guidance/ta48http://www.nice.org.uk/http://www.nice.org.uk/http://www.nice.org.uk/guidance/ta48http://www.nice.org.uk/guidance/ta48http://www.nice.org.uk/guidance/cg15http://www.nice.org.uk/guidance/ph1http://www.nice.org.uk/guidance/ta117http://www.nice.org.uk/guidance/ta117http://www.nice.org.uk/guidance/ta164http://www.nice.org.uk/guidance/cg87http://www.nice.org.uk/guidance/cg91http://www.nice.org.uk/guidance/ph25http://www.nice.org.uk/guidance/cg108http://www.nice.org.uk/guidance/cg114http://www.nice.org.uk/guidance/cg125http://www.nice.org.uk/guidance/cg127http://www.nice.org.uk/guidance/ta249http://www.nice.org.uk/guidance/ta256http://www.nice.org.uk/guidance/ta256http://www.nice.org.uk/guidance/ta261http://www.nice.org.uk/guidance/ta261http://www.nice.org.uk/guidance/cg146

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A= H = @ K=H F= =M =GG (IH). #CE I=@=.

I@=H= LH $I@M 2015.

M 1 =HG (IH). #CE I=@=. I@=H= LH AIIGH 2015.

M 2 =HG (IH). #CE I=@=. I@=H= LH AIIGH 2015.



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55 !I=@= D !I=@= DJJ@H !FI, H=@ C@@F@H !FI, H=@ C@@FH= CHFH= CHF

#CE FH H #CE FH H

5.1G$%% D%%/0% G/0

!I=@= DJ@H !FI FG @=GH F HG F H 2014 IH. F H

G=H= FJ=IG !I=@= DJ@H !FIG, G H I@@ I=@=.

I@ DI@ D'IN'IN

@ CI=HM IFG =@=GH, M@ DJ ELHF FIGH

"I !@@F"I !@@F

CGI@HH F@=GH, EG H "@=F =JFG=HM "G=H@, IFFM

HFM !F=THHFM !F=TH

F==@ = !F@ FH= M@ C@@ !F@ FH=H=FG @==@ = F

=M F, =HM "@H, F

F $=GF $=G

CGI@HH IFG @ FJ=G, EGH H "G=H@G =JFG=HM " IH= FIGH

I@ I@ FKFK

@ F=GH, "I@@ EGH FG=F " FIGH

EI &EI &

CGI@HH C@==@ =H=GH, EGH H "G=H@G =JFG=HM " IH= FIGH

FH &FH &K=GK=G

CGI@HH @ MG==, I A@LF "G=H@, FHGIH

= &= &II

H=H FF F, BF=H=G =M H=H AGG=H=

@ @ '=F'=F

CGI@HH !F=HF= !F@ ==, EGH H "G=H@G =JFG=HM " IH= FIGH

=@G =@G @F@F

H=H FF F, H=@ =M FH=


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I@ F=I@ F=

FGGF I@= "@H, =JFG=HM IHH

I@ HI@ HJJG (G (C=F)C=F)

CGI@HH F@=GH, EGH H "G=H@G =JFG=HM " IH= FIGH

5.2 N!/! C#! G$%% C%%

CF@= B@= (IH=@ CF@= B@= (IH=@ JJF 2013)F 2013)

GF @@K

&=GH "-$G (IH=@ F 2013), I'M&=GH "-$G (IH=@ F 2013), I'M CI (F AF=@ 2013 H $I 2013), F CI (F AF=@ 2013 H $I 2013), F

CFJ=@@ (F $I@M 2013), F " (F HF 2013 H CFJ=@@ (F $I@M 2013), F " (F HF 2013 H FIFM 2014), A@= GKFHFIFM 2014), A@= GKFH(F (F FIFM 2014)FIFM 2014)

FH F

&=@= &= (IH=@ AIIGH 2013)&=@= &= (IH=@ AIIGH 2013)

"@H E=GH

$=@@ $=@@ F (IH=@ AIIGH 2013), F CFJ=@@ (F HF 2013)F (IH=@ AIIGH 2013), F CFJ=@@ (F HF 2013)

!I=@= &

F K= (IH=@ F K= (IH=@ FIFM 2013), F CFJ=@@ (F FIFM 2013), F CFJ=@@ (F FIFM 2013 H $I@M 2013)FIFM 2013 H $I@M 2013)

=F GF @@K

=F =HH (IH=@ =F =HH (IH=@ FIFM 2013), $ AG (F F 2013)FIFM 2013), $ AG (F F 2013)

#FH= =H=GH

DDJ= J= F@=F@=

IFJ=G= "@H E=GH

5.3 NICE 0/*%# %!

FH= A@@FH= A@@MM

C@==@ AJ=GF

FF =@@HH =@@HH

AGG=H D=FHF



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B DB D

!I=@= C=GG== F

$$M CFJ=@@M CFJ=@@

!I=@= CF=HF

HHJJ BFG BFG

=@ &

$G "$G "MFMF

"@H E=GH

CHF= B-D=HFCHF= B-D=HFE=HF



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CG HF I@=H=CG HF I@=H=

F 2015:F 2015: =F =H.

$IFM 2015:$IFM 2015: K GH=, =@HH=: HH= GHFH, .

HF 2014:HF 2014: =F =H.


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AIH H=G I=@=AIH H=G I=@=

#CE @==@ I=@=G F FH=G IH H HFHH F @ K=H G=T

=GGG =H=G.

#CE I=@=G F J@ = F K=H G HH TG KH H I=@= K=@@

K=@@ H JF.

=G I=@= KG J@ M H H=@ C@==@ !I=@= CHF, K= =G G H H M@

C@@ MG==G. CHF KF K=H !I=@= DJ@H !FI, F=G=

@HF FGG=@G (=@I= GI@HHG, !G IFGG), H=HG FFG, H=@

GH, K= FJ=K H J= FH H FH=G. FH=G KF

T@=G HF I@= GI@HH=.

HG FGGG F J@= #CE @==@ I=@=G F GF= = H I=@=G

I@.

#CE FIG I=, GHFG =FH= =GG== FJ== =-I@=HM

@HF, G=@ F, I@= @H GFJ=G. J FHG H FJ= FH= #CE

GFJ=G H @G, H@ FHF #F@. D=G=G K #CE I= HF

FIHG @M = HG IHF=G F M ==GHFG = H @G JFH, HH=GJFH, FHF #F@ ELIH=J. #CE I= F HF FIHG M =@I

FFG H F=GH=G F @ FGG=@ F =GG== F FJ== F HH M

F@JH @M H E@.

U0$!% &/!/

=G I=@= IHG F@G #CE I=@= C!73 (I@=G HF 2008).


http://www.nice.org.uk/Guidance/CG182/Documentshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/About/What-we-do/Our-Programmes/NICE-guidance/NICE-guidelines/NICE-clinical-guidelineshttp://www.nice.org.uk/Guidance/CG182/Documents

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H=G F F G 20082008, 2008, 20142008, 2014, 20142014 F K 2014K 2014:

20082008 ==HG HH H J= G H FJ=K G= 2008

2008, 20142008, 2014 ==HG HH H J= G H FJ=K G= 2008, IH

G J H H FH= KF= HH H =

20142014 ==HG HH H J= G FJ=K IH G H H

F H=

K 2014K 2014 ==HG HH H J= G FJ=K H FH= G

IH F .

H=G F #CE I=@= C!73 (2008) HH H=G F #CE I=@= C!73 (2008) HH JJ

H=G F @@@ 2008, 20142008, 2014 = H J= G H FJ=K IH

G J H H FH= KF= HH H =.

H= = 2008H= = 2008

I=@=I=@=

H= =H= =

IFFH I=@=IFFH I=@=

G F G F

HH =H=M

FH=IF=, IG IF= AC =

FF, G =H G FHF

GG=H=J=HM H C F @K

@J@G FH=IF=. F

IH=TH= =HF=

FH=IF=, C IG

G @HFH=J. AC =G H

F H F

@ K=H =HG. (1.1.11)

HH =H=M

FH=IF=, IG IF=

AC = FF H

FH=:FH==

FH= (C), IG =H

G FHF GG=H=J=HM

H C F @K

@J@G FH=IF=.

F IH=TH=

=HF= =@J@G FH=IF=

(AC 70 /@ F

F), C

IG G @HFH=J.

AC =G H

F

H F @

K=H =HG. (1.1.18)

'"= @J@G FH=IF=' H

AC HFM KG F

@F=TH= IH=TH=

=HF=.



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F H ==H=@ HH=

FH=IF=, = H AC =G

30 /@ F F (H=G =G

FL=H@M I=J@H H

C 50 /@ F F, F

IF=FM FH= LFH= 0.5 /

24 F F) @GG H

70 /@ (FL=H@M

I=J@H H C @GG H

100 /@, F IF=FM

FH= LFH= @GG H 1 /

24 ) H=G GI@ TF

M GIGIH F@M F=

G@. # H ==H=@ AC =G

70 /@ F F, F H

C 100 /@ F F,

FH G@ H

HGH. (1.1.12)

F H ==H=@

HH=

FH=IF=, = H

AC =G HK 3 /

@ 70 /

@, H=G GI@

TF M

GIGIH F@M

F= G@. # H

==H=@ AC =G 70 /

@ F F,

FH G@

H HGH. (1.1.19)

F=HF= F @==@@M G==TH

FH=IF= J F

AC 30 /@ F F H

3 /@ F F. A@HI H=G

IGH= KG H =FH@M =@I =

H IH, H F

J= FJ=K F H FFG

=M @GG=TH=

CD GH=G. !D! F

HH H F=G JFG IHG =G

H=II GHFHG H AC

K@@ @K 30 /@.

I=J@G H C

IF=FM FH= LFH= KF

FJ IG H J=

GK HH AC KG F

IFH.

# @ K=HIH =HG

G=F @==@@M G==TH

FH=IF= H FGH K

H AC =G 30 /@ F

F (H=G =G FL=H@M

I=J@H H C 50 /@

F F, F IF=FM FH=

LFH= 0.5 /24 F

F).(1.1.13)

F TF

AC 3 /@ F

F G @==@@M

=FHH FH=IF=.

(1.1.20)

@ K=H FH=

1.1.20.


FH=IF= J F

AC 30 /@ F F H

3 /@ F F. A@HI H=G


H IH, H F

J= FJ=K F H FFG

=M @GG=TH=

CD GH=G. !D! F

HH H F=G JFG IHG =G

H=II GHFHG H AC

K@@ @K 30 /@.



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# @ K=H =HG

G=F =F@I=IF=

(AC F H 2.5 /@

= AC F H

3.5 /@ = K) H

@==@@M G==TH. (1.1.14)

F TF

AC 3 /@ F

F G @==@@M

=FHH FH=IF=.

(1.1.20)

@ K=H FH=

1.1.20


FH=IF= J F AC 30 /@ F F H

3 /@ F F. A@HI H=G


H IH, H F

J= FJ=K F H FFG

=M @GG=TH=

CD GH=G. !D! F

HH H F=G JFG IHG =G

H=II GHFHG H AC

K@@ @K 30 /@. F =G

F@ J KM F H HF

'=F@I=IF=' (AC HK 3

30 /@) H !D!

KH H @HGH FH=G

H FUH H=G.

A=H=@@M =H KG @F @H

FF=H H J =FH

F=HF= F F. !D! KG H

KF M J= K= H

F =FG KF G.

A@@ @ K=H =HG,

@ K=HIH =HG K=H

! @GG H 60 @/=/

1.73 2, GI@ J H=F

IF=FM @I=/FH=

LFH= IH=T. TFGH

F@ FGI@H GI@

TF F@M F=

G@ (= H FJ=IG@M

H=).(1.1.15)

IH=M IF=FM

@I= F IF=FM

FH= @GG G =

FH=

1.1.18 F:

@ K=H

=HG

@ K=HIH

=HG K=H

! @GG H

60 @/=/1.73 2

(1.1.21)

G FH H F==@

FH= (FF=

TF= F@M F=

G@) KG FJ IG

=T F=HF= F FJ= =

FH= 1.1.19.

HF G F @F=TH= @M

R G @F=TH= H@.



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=HF ! = @

FGF= FIG K H

FHL= GI G @=IF=

===HFG @=H=I. C

! H @GH I@@M = @

F=J= @-HF GMGH=

-GHF=@ H=-

=UHFM FI (A#D)

HFHH. (1.1.21)

=HF ! H @GH

I@@M = @

FGF= FIG

K H

FHL=, GI G

@=IF= ===HFG

(F L@

M@GF= F

HF@=IG), @=H=I

-GHF=@

H=-=UHFM

FIG (A#DG).

2008,

2014

FIM =HF= KG

F FHL= FIG G

H BF=H=G H=@ FI@FM,

K= @F ==HG

=F = =HF= G

HK A#DG HF

FHL= FIG. AI@

=HF= KG F M H !D!

G FF=H F @@ HG FIG.

EL@G @=IF= ===HFG

KF F @F=TH=.

# H G H J F=G

HFG, H IG , F

F H==HM G F=G FFG H

HGH @ F CD. # H

G H@=

GMF, =HG F

MFHG=, H IG

G=HM @ G F=G FF

H HGH @ F CD. (1.1.23)

D H IG ,

F F H==HM G

F=G FFG H HGH

@ F CD. # H

G H@=

GMF, =HG F

MFHG=, H

IG G=HM @ G

F=G FF H HGH

@ F CD.

(1.1.29)

==H=@ FH H GH '#

H G H J F=G

HFG' KG FJ.

2008 FH= =@=

HH = F=G HFG KF FGH H

, F H==HM I@ G=F G F=G HFG. !D!

= H T M J= F H=G

F HH FKF= H

FH= FHG I@=HM.



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F H IFGG H=G

@GG=TH= T FH=IF=

G IF=FM AC 30 /@ F

F, F C 50 /@ F

F (FL=H@M

I=J@H H IF=FM FH=

LFH= 0.5 /24 IFG F

F). (1.2.2)

F TF

AC 3 /@ F

F G @==@@M

=FHH FH=IF=.

(1.1.20)


FH=IF= J F

AC 30 /@ F F H

3 /@ F F. A@HI H=G


H IH, H F

J= FJ=K F H FFG

=M @GG=TH=

CD GH=G. !D! F

HH H F=G JFG IHG =G

H=II GHFHG H AC

K@@ @K 30 /@.

I=J@G H C IF=FM

FH= LFH= KF FJ

IG H J= GK HH

AC KG F IFH.



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F F@ I@HFGI H @@

@ K=H CD K:

J FFGG=J CD

(! @= F H5 @/=/1.73

2K=H=

1 MF, F F H 10 @/

=/1.73 2

K=H= 5 MFG)

J J=G=@ F FG=GHH

=J=G=@ HIF=

J GMHG IF=FM

HFH GHFIH=

J =@M =GHFM

@MMGH= =M =GG

F JF 20

J GH 4 F 5 CD

F G=F M

F@=GH H FI=F

F@ =GM. (1.4.1)

F F@

I@HFGI G H @@

@ K=H CD K:

J @FHFFGG=

CD (G

FH=

1.3.3)

J J=G=@ F

FG=GHH =J=G=@

HIF=

J GMHG

IF=FM HFH

GHFIH=

J =@M

=GHFM

@MMGH= =M

=GG F

JF 20 MFG

J ! @GG

H 30 @/=/

1.73 2

(!

HFM !4 F !5)

F G=F M

F@=GH H

FI=F F@

=GM. (1.2.5)

TFGH I@@H =H KG =T H

FUH H IH I=@=

T=H= FFGG= G

H J= FJ=K = H

FIM =HF= GH= (G

FH= 1.3.5).



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H @@K= GHG H

=H=M FFGG=J CD.

H= ==I HF

! GH=H=G JF F= H @GG H

90 MG.

# @ K=H K T=

FI !, FH H

! K=H= 2 KG H

L@I IGG IH

HF=FH= ! R F

L@, IH =M =IFM

F ==H=H= ACE

===HF/AB HFM.

DT FFGG= G

@= = ! F

H 5 @/=/1.73 2

K=H= 1 MF, F F H

10 @/=/1.73 2 K=H=

5 MFG.

IG FH=I@F@M HG

= K @= !

H=I= H H GFJ

FH KI@ @ H H

F F@ F@H

HFM K=H= H=F @=H=

M LHF@H= H IFFHFH @=. (1.5.1)

H @@K=

GHG H =H=M H

FH FFGG=

CD:

H= ==I

3 !

GH=H=G JF

F= H @GG

H 90 MG.

# @ K=H

K T=

FI !,

FH H !

K=H= 2 KG H

L@I IGG

IH

HF=FH=

! R F L@,

IH =M =IFM

F GHFH=F=R=HG=

GMGH H=GH

HFM. (1.3.4)

B KF HH @

K=H CD F H

=FG F=G

FFGG= H -

GH =M =GG =

HM J =HF

H @@K=:

GIGH=

FG = !

25% F F JF

12 HG F

TFGH 2 I@@H =HG H 2008

FH= KF =H

GFH FH= (1.3.4) H

G=G H FGG H =H=M

FFGG=J CD.

H=F I@@H =H KG IH

(1.3.5) G J= F=J

F H FIM =HF=

FJ=K, K= =H=T HFG@G

F FFGG=.

!D! GFH

FH= (1.3.6) F HIFH I@@H =H H =J =H

=H=@ IG, @F=T H

KF= F= H #CE IG

GHM@.



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GIGH=

FG = !

15 @/=/1.73 2

F F JF

12 HG. (1.3.5)

GGGG= CD

FFGG=,

LHF@H H

IFFH FH @=

! H H=G

=H IH K

@= =HFJH=GHFH=G,

FH=I@F@M = =H

GIGHG HH H

FG =H

F@ F@H

HFM = H=F

@=H=. (1.3.6)



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@ K=H CD = H

@@K= FIG GI@

F@@M FFF F

G=@=GH GGGGH:

GH 4 5 CD (K=H F

K=HIH =HG)

=F @J@G FH=IF=

(AC 70 /@ F F,

FL=H@M I=J@H H

C 100 /@ F F,

F IF=FM FH= LFH=

1 /24 F F) I@GG

K H I H =HG

@FM FF=H@M

HFH

FH=IF= (AC 30 /

@ F F,

FL=H@M I=J@H H

C 50 /@ F F,

F IF=FM FH= LFH=

0.5 /24 F F) HHF

K=H HIF=

F=@M @== !

(F H 5 @/=/

1.73 2

= 1 MF, F F

H 10 @/=/1.73 2

K=H= 5 MFG)

MFHG= HH F=G

F@M HF@@ G=H

H IG H @GH IF

H=MFHG=J FIG H

HFIH= GG (G @G

'"MFHG=: H

MFHG= = I@HG =

@ K=H CD =

H @@K= FIG

GI@ F@@M

FFF F G=@=GH

GGGGH:

! @GG H

30 @/=/1.73 2

(! HFM !4

F !5), K=H F

K=HIH =HG

AC 70 /@

F F (AC

HFM A3),

I@GG K H

IG M =HG

@FM

FF=H@M

HFH

AC 30 /@

F F (AC

HFM A3),

HHF K=H

HIF=

GIGH= FG

= ! 25% F

F

= ! HFM FGIGH= FG

= ! 15 @/

=/1.73 2

F

F K=H=

12 HG

MFHG= HH

F=G F@M

TFGH I@@H =H KG

H =J ! J@IG FHF H H

GHG H @ @F=M H F=HF=.

# H G I@@H =H HI=J@ H C J@I KG

FJ H GIF G=GHM

AC IG.

# H IFH I@@H =H H

T=H= FFGG= KG

H H 2014 T=H= (G

FH= 1.3.5).

TH I@@H =H KG H FGG FF H IFFH #CE

I=@= MFHG=.



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F=FM F' #CE

I=@= C!34)

@ K=H, F GIGH

J=, FF F H=IGG CD

GIGH F@ FHFM

GHG=G. (1.6.1)

HF@@ G=H

H IG H @GH 4

H=MFHG=J

FIG H

HFIH= GG

(G @G

"MFHG=

#CE I=@=

C!127)

K F

GIGH FF

F H= IGG CD

GIGH F@

FHFM GHG=G.

2008,

2014 (1.5.2)

F =HFM J= H @

K=H FFGG=J CDF= HGG=I,

GH, FH=, @F=

G@H =H K ==H.

(1.7.4)

F =HFM J=

IH HGG=I,GH, @F=

G@H =H

FF=H H H

GJF=HM CD.

(1.4.7)

FH= KG FJ IG H=G

KG GIH H K J=FJ=K.

!D! FKF H

FH= H GHH HH

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