ꯅꯍꯥꯛꯀꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕ꯭ꯔꯥ, ꯅꯠꯠꯔꯒꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯂꯥꯌꯅꯥ (CKD) ꯍꯥꯌꯅꯥ ꯀꯧꯕꯥ ꯂꯥꯌꯅꯥ ꯂꯩꯕ꯭ꯔꯥ ? ꯅꯠꯠꯔꯒꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯅꯥ ꯅꯥꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯥ ꯅꯍꯥꯛꯅꯥ ꯈꯪꯂꯕ꯭ꯔꯥ? ꯃꯤꯑꯣꯏ ꯀꯌꯥꯅꯥ ꯈꯜꯂꯤ ꯃꯗꯨꯗꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯍꯥꯌꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯃꯁꯤꯅꯥ ꯀꯤꯗꯅꯤ ꯈꯛꯇꯗꯥ ꯁꯣꯀꯍꯜꯂꯤ꯫ ꯑꯗꯨꯕꯨ ꯑꯆꯨꯝꯕꯥ ꯑꯗꯨꯗꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯀꯤꯗꯅꯤꯁꯤꯡꯅꯥ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯊꯕꯛ ꯇꯧꯗꯕꯥ ꯃꯇꯃꯗꯥ ꯍꯀꯆꯥꯡꯒꯤ ꯑꯇꯣꯞꯄꯥ ꯁꯤꯁ꯭ꯇꯦꯝ ꯀꯌꯥꯗꯥ ꯑꯆꯧꯕꯥ ꯁꯥꯐꯨ ꯑꯃꯥ ꯄꯤꯕꯥ ꯌꯥꯏ, ꯃꯔꯨꯑꯣꯏꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯁ꯭ꯀꯦꯂꯦꯇꯦꯜ ꯁꯤꯁ꯭ꯇꯦꯃꯗꯥ, ꯍꯥꯌꯕꯗꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡꯗꯥ . ꯑꯗꯨꯅꯥ, ꯉꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡ ꯁꯣꯟꯊꯔꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯁꯃꯁ꯭ꯌꯥ ꯊꯣꯀꯍꯜꯂꯤꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯔꯤ꯫ ꯃꯁꯤꯕꯨ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯑꯣꯏꯅꯥ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯍꯥꯌꯅꯥ ꯀꯧꯏ . ꯃꯃꯤꯡ ꯑꯁꯤ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯂꯨꯝꯂꯕꯁꯨ, ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯂꯧꯁꯤ꯫

⚡ Interactive Clinical Tool

🫘

Renal function (eGFR)

Measure kidney function based on creatinine value

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ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯍꯥꯌꯕꯁꯤ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ (CKD) ꯂꯩꯕꯥ ꯑꯍꯂꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯑꯉꯥꯡꯁꯤꯡ ꯑꯅꯤꯃꯛꯇꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯕꯥ ꯁꯔꯨꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯃꯅꯤ꯫

ꯍꯧꯖꯤꯛ, ꯌꯦꯡꯎ, ꯑꯩꯈꯣꯌꯒꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯊꯧꯗꯥꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯑꯃꯅꯤ꯫ ꯍꯥꯌꯕꯗꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯐꯣꯁꯐꯣꯔꯁꯒꯨꯝꯕꯥ ꯃꯤꯅꯔꯦꯂꯁꯤꯡꯒꯤ ꯆꯥꯡ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯅꯤ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯀꯤꯗꯅꯤꯁꯤꯡꯅꯥ ꯚꯤꯇꯥꯃꯤꯟ D ꯑꯦꯛꯇꯤꯚ ꯑꯣꯏꯍꯟꯗꯨꯅꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯀꯧꯕꯥ ꯍꯣꯔꯃꯣꯟ ꯑꯃꯥ ꯄꯨꯊꯣꯀꯏ, ꯃꯗꯨꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡꯕꯨ ꯃꯄꯥꯉ꯭ꯒꯜ ꯀꯅꯈꯠꯍꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯀꯤꯗꯅꯤꯁꯤꯡꯅꯥ ꯁꯣꯀꯍꯜꯂꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯊꯕꯛ ꯇꯧꯗꯕꯥ ꯃꯇꯃꯗꯥ, ꯃꯈꯣꯌꯅꯥ ꯃꯤꯅꯔꯦꯂꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯆꯥꯡ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯟ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯁꯤ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯥ ꯉꯃꯗꯦ꯫ ꯃꯗꯨꯗꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯁꯣꯀꯄꯥ ꯍꯧꯔꯀꯏ . ꯃꯁꯤꯅꯥ ꯁꯔꯨꯁꯤꯡ ꯐꯖꯅꯥ ꯁꯣꯀꯍꯅꯕꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯅꯒꯠꯍꯜꯂꯤ, ꯃꯁꯤꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯐ꯭ꯔꯦꯀꯆꯔ .

ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯍꯀꯆꯥꯡ ꯐꯅꯥ ꯊꯝꯕꯗꯥ ꯀꯔꯤ ꯃꯤꯅꯔꯦꯂꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯅꯁꯤꯡꯅꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯕꯒꯦ?

ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯍꯀꯆꯥꯡ ꯐꯅꯥ ꯑꯃꯁꯨꯡ ꯃꯄꯥꯉ꯭ꯒꯜ ꯀꯅꯈꯠꯍꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯂꯤꯕꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯟ ꯀꯌꯥ ꯂꯩ꯫ ꯃꯈꯣꯌꯒꯤ ꯃꯔꯃꯗꯥ ꯈꯔꯥ ꯈꯉꯂꯁꯤ꯫

ꯀꯦꯂꯁꯤꯌꯝ: ꯃꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯀꯝꯄꯣꯅꯦꯟꯇꯅꯤ꯫ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯗꯥ "ꯀꯦꯂꯁꯤꯌꯝ ꯕꯦꯉ꯭ꯛ" ꯑꯃꯒꯨꯝꯅꯥ ꯂꯩ꯫ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯁꯤꯅꯥ ꯁꯔꯨꯁꯤꯡ ꯃꯄꯥꯉ꯭ꯒꯜ ꯀꯅꯈꯠꯍꯅꯕꯇꯥ ꯅꯠꯇꯅꯥ ꯑꯇꯩ ꯄꯣꯠꯂꯝ ꯀꯌꯥꯒꯤꯗꯃꯛꯇꯁꯨ ꯇꯉꯥꯏꯐꯗꯕꯥ ꯑꯣꯏ, ꯃꯗꯨꯗꯤ ꯅꯔꯚꯁ ꯁꯤꯁ꯭ꯇꯦꯃꯒꯤ ꯊꯕꯛ ꯇꯧꯕꯥ ꯑꯃꯁꯨꯡ ꯃꯁꯂꯒꯤ ꯊꯕꯛ ꯊꯧꯔꯃꯁꯤꯡ ꯑꯁꯤꯅꯆꯤꯡꯕꯥ꯫ ꯑꯩꯈꯣꯌꯒꯤ ꯀꯤꯗꯅꯤꯅꯥ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯂꯦꯚꯦꯜ ꯕꯦꯂꯦꯟꯁ ꯇꯧꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫
ꯐꯣꯁꯐꯔꯁ: ꯀꯦꯂꯁꯤꯌꯝ ꯑꯁꯤꯒꯨꯝꯅꯥ ꯐꯣꯁꯐꯔꯁ ꯑꯁꯤꯁꯨ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯆꯥꯛ ꯑꯃꯅꯤ꯫ ꯑꯩꯈꯣꯌꯒꯤ ꯀꯤꯗꯅꯤꯅꯥ ꯍꯀꯆꯥꯡꯅꯥ ꯃꯊꯧ ꯇꯥꯗꯕꯥ ꯑꯍꯦꯅꯕꯥ ꯐꯣꯁꯐꯔꯁ ꯂꯧꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯐꯣꯁꯐꯔꯁꯀꯤ ꯃꯔꯛꯇꯥ ꯃꯇꯤꯛ ꯆꯥꯕꯥ ꯕꯦꯂꯦꯟꯁ ꯑꯃꯥ ꯊꯝꯃꯤ꯫
ꯀꯦꯂꯁꯤꯌꯝ: ꯃꯁꯤ ꯚꯤꯇꯥꯃꯤꯟ ꯗꯤꯒꯤ ꯑꯦꯛꯇꯤꯚ ꯑꯣꯏꯕꯥ ꯃꯑꯣꯡꯅꯤ, ꯃꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯀꯤꯗꯅꯤꯅꯥ ꯁꯦꯝꯕꯅꯤ꯫ ꯍꯣꯔꯃꯣꯟ ꯑꯁꯤꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯆꯥꯔꯤꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡꯗꯒꯤ ꯀꯌꯥ ꯌꯥꯝꯅꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯂꯧꯕꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ ꯑꯃꯁꯨꯡ ꯑꯩꯈꯣꯌꯒꯤ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯒ꯭ꯜꯌꯥꯟꯗꯁꯤꯡꯁꯨ ꯊꯕꯛ ꯇꯧꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫
ꯐꯥꯏꯕ꯭ꯔꯣꯕ꯭ꯂꯥꯁ꯭ꯠ ꯒ꯭ꯔꯣꯊ ꯐꯦꯛꯇꯔ ꯲꯳ (ꯑꯦꯐ.ꯖꯤ.ꯑꯦꯐ.꯲꯳):ꯃꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯅꯥ ꯄꯨꯊꯣꯀꯄꯥ ꯍꯣꯔꯃꯣꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯐꯣꯁꯐꯔꯁ ꯑꯃꯁꯨꯡ ꯚꯤꯇꯥꯃꯤꯟ Dꯒꯤ ꯆꯥꯡ ꯔꯤꯒꯨꯂꯦꯠ ꯇꯧꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫ ꯃꯍꯧꯁꯥꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ FGF23ꯒꯤ ꯆꯥꯡ ꯋꯥꯡꯏ꯫
ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH): ꯃꯁꯤꯒꯤ ꯍꯣꯔꯃꯣꯟ ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯀꯣꯛꯇꯥ ꯊꯥꯌꯔꯣꯏꯗ ꯒ꯭ꯜꯌꯥꯟꯗꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯂꯩꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯒ꯭ꯜꯌꯥꯟꯗ ꯃꯔꯤꯅꯥ ꯄꯨꯊꯣꯀꯏ꯫ ꯃꯁꯤꯕꯨ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯒ꯭ꯜꯌꯥꯟꯗ ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯁꯤꯒꯤ ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.ꯍꯣꯔꯃꯣꯟ ꯑꯁꯤꯒꯤ ꯊꯕꯛ ꯑꯁꯤ ꯍꯀꯆꯥꯡꯅꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯃꯊꯧ ꯇꯥꯕꯥ ꯃꯇꯃꯗꯥ ꯁꯔꯨꯗꯒꯤ ꯀꯦꯂꯁꯤꯌꯝ ꯊꯥꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯂꯦꯚꯦꯜ ꯂꯦꯡꯗꯅꯥ ꯂꯩꯍꯅꯕꯅꯤ꯫

✨ Muscle recovery Verified Partner

Magnesium Muscle and Joint Care

A natural magnesium treatment that relieves muscle spasms, frizz and sore muscles.

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ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯂꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯑꯩꯈꯣꯌꯅꯥ ꯅꯍꯥ ꯑꯣꯏꯔꯤꯉꯩꯗꯥ ꯁꯔꯨꯁꯤꯡ ꯍꯦꯅꯒꯠꯂꯀꯏ꯫ ꯑꯗꯨꯕꯨ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯍꯜ ꯑꯣꯏꯔꯀꯄꯥ ꯃꯇꯃꯗꯁꯨ ꯑꯩꯈꯣꯌꯒꯤ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯁꯨꯞꯅꯇꯒꯤ ꯐꯃꯗꯨꯅꯥ ꯂꯩꯕꯥ ꯅꯠꯇꯦ꯫ ꯃꯈꯣꯌꯁꯤꯡ ꯑꯁꯤ ꯂꯦꯞꯇꯅꯥ ꯅꯧꯅꯥ ꯁꯦꯃꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯁꯦꯃꯖꯤꯟ-ꯁꯥꯖꯤꯅꯕꯒꯤ ꯊꯕꯛ ꯆꯠꯊꯔꯤ꯫ ꯑꯔꯤꯕꯥ ꯏꯔꯤꯒꯦꯁꯅꯁꯤꯡ ꯂꯧꯊꯣꯛꯇꯨꯅꯥ ꯑꯅꯧꯕꯥ ꯏꯔꯤꯒꯦꯁꯅꯁꯤꯡ ꯊꯃꯗꯨꯅꯥ ꯋꯥꯜ ꯑꯃꯥ ꯁꯥꯕꯒꯨꯝꯅꯥ, ꯑꯔꯤꯕꯥ ꯁꯔꯨꯒꯤ ꯇꯤꯁꯨꯁꯤꯡ ꯑꯁꯤ ꯁꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯑꯅꯧꯕꯥ ꯁꯔꯨꯒꯤ ꯇꯤꯁꯨꯁꯤꯡ ꯁꯦꯝꯃꯤ꯫ ꯑꯩꯈꯣꯌꯅꯥ ꯊꯧꯑꯣꯡ ꯑꯁꯤꯕꯨ "ꯕꯣꯟ ꯇꯔꯅꯑꯣꯚꯔ" ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯕꯣꯟ ꯇꯔꯅꯑꯣꯚꯔ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯅꯠꯠꯔꯒꯥ ꯌꯥꯝꯅꯥ ꯇꯞꯅꯥ ꯂꯩꯔꯕꯗꯤ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯈꯜ ꯃꯔꯤ ꯂꯩ: ꯱.

ꯑꯣꯁ꯭ꯇꯦꯏꯇꯤꯁ ꯐꯥꯏꯕ꯭ꯔꯣꯁꯥ (Osteitis Fibrosa): ꯃꯁꯤ ꯕꯣꯟ ꯇꯤꯁꯨꯁꯤꯡ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯁꯣꯀꯍꯜꯂꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯍꯦꯅꯒꯠꯂꯀꯄꯅꯥ ꯊꯣꯀꯍꯅꯕꯅꯤ꯫ ꯃꯁꯤꯕꯨ ꯍꯥꯏꯄꯔꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗꯤꯖꯝ ꯍꯥꯌꯅꯥ ꯀꯧꯏ .
ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥ (Osteomalacia): ꯃꯁꯤ ꯁꯔꯨ ꯇꯥꯡꯒꯤ ꯇꯤꯁꯨꯁꯤꯡ ꯁꯣꯟꯊꯔꯀꯄꯒꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ, ꯑꯗꯨꯕꯨ ꯑꯅꯧꯕꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯤ ꯌꯥꯝꯅꯥ ꯇꯞꯅꯥ ꯁꯦꯃꯒꯠꯂꯀꯏ꯫ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯁ꯭ꯄꯣꯟꯖ (sponji) ꯑꯃꯁꯨꯡ ꯁꯣꯟꯊꯕꯥ ꯑꯣꯏꯔꯀꯏ꯫ ꯃꯁꯤ ꯚꯤꯇꯥꯃꯤꯟ D ꯋꯥꯠꯄꯥ, ꯙꯥꯇꯨꯒꯤ ꯄꯣꯠꯁꯀꯁꯤꯡ, ꯑꯃꯁꯨꯡ ꯑꯀꯛꯅꯕꯥ ꯃꯈꯂꯒꯤ ꯀꯦꯟꯁꯔꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯍꯣꯔꯃꯣꯟ FGF23 ꯍꯦꯟꯅꯥ ꯄꯨꯊꯣꯀꯄꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯑꯦꯗꯥꯏꯅꯥꯃꯤꯛ ꯕꯣꯟ ꯗꯤꯖꯤꯖ (Adynamic Bone Disease): ꯃꯁꯤ ꯕꯣꯟ ꯇꯤꯁꯨꯁꯤꯡ ꯁꯦꯝꯕꯥ ꯑꯃꯁꯨꯡ ꯔꯤꯄꯦꯌꯥꯔ ꯇꯧꯕꯥ ꯌꯥꯝꯅꯥ ꯍꯟꯊꯔꯀꯄꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯃꯗꯤ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯅꯦꯝꯕꯥ ꯑꯁꯤꯅꯤ꯫
ꯃꯤꯛꯁ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ (mixed Renal Osteodystrophy): ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯅꯥ ꯑꯣꯁ꯭ꯇꯦꯇꯤꯁ ꯐꯥꯏꯕ꯭ꯔꯣꯁꯥ ꯑꯃꯁꯨꯡ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥ ꯑꯅꯤꯃꯛꯀꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯄꯨꯅꯁꯤꯜꯂꯤ꯫

ꯍꯧꯖꯤꯛ ꯃꯈꯂꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯑꯀꯨꯞꯄꯥ ꯃꯔꯣꯂꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯁꯤ꯫

ꯑꯣꯁ꯭ꯇꯦꯏꯇꯤꯁ ꯐꯥꯏꯕ꯭ꯔꯣꯁꯥ꯫

ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯋꯥꯡꯈꯠꯂꯀꯄꯥ ꯍꯥꯌꯕꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯌꯥꯝꯕꯅꯥ ꯇꯥꯕꯥ ꯐꯪꯏ꯫ ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.ꯅꯥ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯃꯒꯤ ꯆꯥꯡ ꯑꯗꯨ ꯕꯦꯂꯦꯟꯁ ꯇꯧꯅꯕꯥ ꯁꯔꯨꯗꯒꯤ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯊꯥꯗꯣꯀꯄꯒꯤ ꯊꯧꯗꯥꯡ ꯂꯧꯏ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯀꯔꯤꯒꯨꯝꯕꯥ PTHꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯂꯕꯗꯤ, ꯃꯁꯤꯅꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯒꯤ ꯀꯦꯂꯁꯤꯌꯝ ꯌꯥꯝꯅꯥ ꯂꯧꯊꯣꯀꯏ꯫ ꯃꯁꯤꯅꯥ ꯁꯔꯨꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯐꯤꯕꯔꯒꯤ ꯁꯤꯁ꯭ꯇꯦꯃꯁꯤꯡ (fibrous cysts) ꯁꯦꯃꯒꯠꯂꯀꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ ꯑꯗꯨ ꯁꯣꯟꯊꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.ꯒꯤ ꯆꯥꯡ ꯍꯦꯅꯒꯠꯂꯀꯄꯒꯤ ꯃꯔꯝ ꯀꯌꯥ ꯂꯩꯔꯤ:

ꯀꯦꯂꯁꯤꯌꯝ ꯋꯥꯠꯄꯥ: ꯀꯤꯗꯅꯤꯁꯤꯡꯗꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯃꯈꯣꯌꯅꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯄꯨꯊꯣꯀꯄꯥ ꯉꯃꯗꯦ, ꯃꯗꯨꯅꯥ ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.
ꯑꯦꯐ.ꯖꯤ.ꯑꯦꯐ.꯲꯳ꯒꯤ ꯆꯥꯡ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ:ꯃꯁꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯒꯤ ꯇꯣꯏꯅꯥ ꯊꯣꯀꯄꯥ ꯈꯨꯗꯝ ꯑꯃꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯅꯥ ꯏꯗꯥ ꯐꯣꯁꯐꯔꯁꯀꯤ ꯆꯥꯡ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ ꯊꯤꯡꯅꯕꯥ ꯁꯔꯨꯁꯤꯡꯗꯒꯤ ꯂꯥꯀꯄꯥ ꯔꯦꯁꯄꯣꯟꯁ ꯑꯃꯁꯨ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫
ꯐꯣꯁꯐꯔꯁ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ : ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯗꯥ ꯐꯣꯁꯐꯔꯁ ꯑꯁꯤ ꯏꯗꯥ ꯊꯨꯃꯖꯤꯜꯂꯤ ꯃꯔꯃꯗꯤ ꯀꯤꯗꯅꯤꯁꯤꯡꯅꯥ ꯃꯗꯨ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯂꯧꯊꯣꯀꯄꯥ ꯉꯃꯗꯦ꯫ ꯃꯁꯤꯅꯥ ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.

ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥ꯫

ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯃꯗꯤ ꯚꯤꯇꯥꯃꯤꯟ ꯗꯤ ꯋꯥꯠꯄꯅꯤ . ꯃꯁꯤ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ ꯀꯃꯟ ꯑꯣꯏ꯫

ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ ꯙꯥꯇꯨ ꯈꯔꯗꯤ ꯙꯥꯇꯨꯒꯤ ꯄꯣꯠꯁꯛ ꯑꯃꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ . ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯑꯦꯂꯨꯃꯤꯅꯤꯌꯃꯒꯨꯝꯕꯥ ꯙꯥꯇꯨꯁꯤꯡꯅꯥ ꯁꯔꯨ ꯇꯥꯡ ꯁꯦꯝꯕꯥ ꯑꯃꯁꯨꯡ ꯁꯦꯟꯅꯕꯗꯥ ꯑꯀꯥꯌꯕꯥ ꯄꯤ꯫ ꯃꯃꯥꯡꯗꯥ ꯐꯣꯁꯐꯔꯁꯀꯤ ꯆꯥꯡ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯅꯕꯥ ꯁꯤꯖꯤꯟꯅꯔꯝꯕꯥ ꯍꯤꯗꯥꯛ ꯈꯔꯗꯥ (ꯐꯣꯁꯐꯦꯠ ꯕꯥꯏꯟꯗꯔꯁꯤꯡ) ꯑꯦꯂꯨꯃꯤꯅꯤꯌꯝ ꯌꯥꯑꯣꯔꯝꯃꯤ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯍꯤꯗꯥꯀꯁꯤꯡ ꯑꯁꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ, ꯃꯔꯨꯑꯣꯏꯅꯥ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯇꯧꯔꯤꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ ꯔꯦꯀꯃꯦꯟꯗ ꯇꯧꯗ꯭ꯔꯦ . ꯅꯟ-ꯑꯦꯂꯨꯃꯤꯅꯤꯌꯝ ꯐꯣꯁꯐꯔꯁ ꯕꯥꯏꯟꯗꯔꯁꯤꯡ ꯍꯧꯖꯤꯛ ꯐꯪꯂꯦ꯫ ꯆꯥꯅꯕꯥ ꯆꯤꯟꯖꯥꯛꯀꯥ ꯂꯣꯌꯅꯅꯥ ꯂꯧꯕꯥ ꯃꯇꯃꯗꯥ, ꯃꯈꯣꯌꯅꯥ ꯆꯤꯟꯖꯥꯛꯇꯥ ꯌꯥꯎꯔꯤꯕꯥ ꯐꯣꯁꯐꯔꯁ ꯑꯗꯨ ꯏꯗꯥ ꯆꯦꯟꯊꯔꯀꯄꯥ ꯊꯤꯡꯏ꯫

ꯀꯦꯟꯁꯔ ꯃꯈꯜ ꯈꯔꯗꯗꯤ ꯍꯣꯔꯃꯣꯟ FGF23 ꯍꯦꯟꯅꯥ ꯄꯨꯊꯣꯀꯄꯁꯨ ꯌꯥꯏ, ꯃꯗꯨꯅꯥ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥ ꯑꯃꯁꯨꯡ ꯕꯣꯟ ꯐ꯭ꯔꯦꯀꯆꯔ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯑꯦꯗꯥꯏꯅꯥꯃꯤꯛ ꯕꯣꯟ ꯗꯤꯖꯤꯖ꯫

ꯃꯁꯤ ꯕꯣꯟ ꯇꯤꯁꯨꯁꯤꯡ ꯁꯦꯝꯕꯥ ꯑꯃꯁꯨꯡ ꯔꯤꯄꯦꯌꯥꯔ ꯇꯧꯕꯥ ꯌꯥꯝꯅꯥ ꯍꯟꯊꯔꯀꯄꯥ ꯃꯇꯃꯅꯤ꯫ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯇꯧꯔꯤꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ ꯌꯥꯝꯅꯥ ꯀꯃꯟ ꯑꯣꯏ꯫ ꯃꯁꯤꯒꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯃꯗꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯚꯤꯇꯥꯃꯤꯟ ꯗꯤꯒꯤ ꯆꯥꯡ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯏ . ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯥꯌꯦꯡꯕꯗꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯑꯍꯦꯅꯕꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯚꯤꯇꯥꯃꯤꯟ D ꯄꯤꯕꯥ ꯃꯊꯧ ꯇꯥꯏ꯫ ꯃꯁꯤꯅꯥ ꯕꯣꯟ ꯇꯔꯅꯑꯣꯚꯔ ꯋꯥꯡꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯊꯤꯡꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯂꯕꯁꯨ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯌꯥꯝꯅꯥ ꯍꯟꯊꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯑꯇꯣꯞꯄꯥ ꯃꯔꯝ ꯀꯌꯥ ꯑꯃꯁꯨ ꯂꯩꯔꯤ:

ꯀꯟꯇꯤꯟꯌꯨꯑꯣꯁ ꯄꯦꯔꯤꯇꯣꯅꯤꯑꯦꯜ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ: ꯃꯁꯤ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯃꯈꯜ ꯑꯃꯅꯤ꯫ ꯃꯐꯝ ꯑꯁꯤꯗꯥ, ꯏ ꯑꯗꯨ ꯑꯦꯕꯗꯣꯃꯤꯅꯦꯜ ꯀꯦꯚꯤꯇꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯁꯦꯡꯗꯣꯀꯏ꯫ ꯃꯁꯤ ꯅꯍꯥꯛꯀꯤ ꯈꯨꯠꯁꯥꯗꯥ ꯂꯩꯕꯥ ꯚꯦꯅꯝ ꯑꯃꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯍꯦꯃꯣꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁꯇꯒꯤ ꯈꯦꯠꯅꯩ꯫ ꯄꯦꯔꯤꯇꯣꯅꯤꯑꯦꯜ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯐ꯭ꯂꯨꯏꯗ ꯈꯔꯗꯤ ꯀꯦꯂꯁꯤꯌꯝ ꯌꯥꯝꯅꯥ ꯌꯥꯎꯏ꯫ ꯃꯁꯤꯅꯥ PTH ꯂꯦꯚꯦꯜ ꯅꯦꯝꯕꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯗꯥꯏꯑꯦꯕꯦꯇꯤꯖ: ꯗꯥꯏꯑꯦꯕꯦꯇꯤꯖꯗꯥ, ꯕ꯭ꯂꯗ ꯁꯨꯒꯔꯒꯤ ꯆꯥꯡ ꯍꯦꯅꯒꯠꯂꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯏꯅꯁꯨꯂꯤꯅꯒꯤ ꯆꯥꯡ ꯍꯟꯊꯔꯀꯄꯅꯁꯨ PTH ꯄꯨꯊꯣꯀꯄꯥ ꯍꯟꯊꯍꯅꯕꯥ ꯉꯝꯃꯤ꯫

CKD-MBD (ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ-ꯑꯦꯁꯣꯁꯤꯑꯦꯠ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯕꯣꯟ ꯗꯤꯁꯑꯣꯔꯗꯔ) ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯑꯩꯈꯣꯌꯒꯤ ꯏꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯃꯤꯅꯔꯦꯂꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯅꯁꯤꯡꯒꯤ ꯕꯦꯂꯦꯟꯁ ꯁꯣꯟꯊꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯁꯤꯅꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯥꯔꯠ ꯑꯃꯁꯨꯡ ꯕ꯭ꯂꯗ ꯚꯦꯁꯦꯂꯁꯤꯡꯗꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ CKD-MBD (ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯕꯣꯟ ꯗꯤꯁꯑꯣꯔꯗꯔ) ꯍꯥꯌꯕꯁꯤ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯑꯃꯁꯨꯡ ꯃꯔꯤ ꯂꯩꯅꯕꯥ ꯀꯥꯔꯗꯤꯑꯣꯚꯥꯁ꯭ꯀꯨꯂꯥꯔ ꯗꯤꯖꯤꯖꯒꯨꯝꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯌꯥꯎꯕꯥ ꯄꯥꯛ-ꯆꯥꯎꯕꯥ ꯋꯥꯍꯩ ꯑꯃꯅꯤ꯫

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯐꯣꯁꯐꯔꯁ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯈꯠꯂꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯁꯤꯅꯥ ꯀꯥꯔꯗꯤꯑꯣꯚꯥꯁ꯭ꯀꯨꯂꯥꯔ ꯗꯤꯖꯤꯖ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯃꯔꯃꯗꯤ ꯀꯦꯂꯁꯤꯐꯤꯀꯦꯁꯟ ꯀꯧꯕꯥ ꯊꯧꯑꯣꯡ ꯑꯃꯅꯤ . ꯍꯥꯌꯕꯗꯤ ꯀꯦꯂꯁꯤꯌꯝ ꯑꯁꯤ ꯕ꯭ꯂꯗ ꯚꯦꯁꯦꯂꯁꯤꯡꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯁꯦꯃꯒꯠꯂꯀꯏ ꯑꯃꯁꯨꯡ ꯊꯃꯖꯤꯜꯂꯤ꯫ ꯃꯁꯤꯅꯥ ꯕ꯭ꯂꯗ ꯚꯦꯁꯦꯂꯁꯤꯡꯒꯤ ꯋꯥꯂꯁꯤꯡ ꯑꯗꯨ ꯇꯔꯨ-ꯇꯅꯥꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯀꯅꯈꯠꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯕꯨ ꯑꯦꯊꯦꯔꯣꯁ꯭ꯀꯂꯦꯔꯣꯁꯤꯁ ꯍꯥꯌꯅꯥ ꯀꯧꯏ . ꯃꯁꯤꯅꯥ ꯍꯥꯏ ꯕ꯭ꯂꯗ ꯄ꯭ꯔꯦꯁꯔ, ꯍꯥꯔꯠ ꯑꯦꯇꯦꯛ, ꯑꯃꯁꯨꯡ ꯁ꯭ꯠꯔꯣꯀꯒꯨꯝꯕꯥ ꯑꯀꯅꯕꯥ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯀꯤꯗꯅꯤꯒꯤ ꯄ꯭ꯔꯣꯕ꯭ꯂꯦꯝ ꯑꯃꯅꯥ ꯀꯌꯥ ꯌꯥꯝꯅꯥ ꯂꯥꯞꯅꯥ ꯆꯠꯄꯥ ꯌꯥꯕꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯈꯟꯗꯨꯅꯥ ꯌꯦꯡꯕꯤꯌꯨ!

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯑꯁꯤ ꯀꯌꯥꯝ ꯀꯃꯟ ꯑꯣꯏꯕꯒꯦ?

ꯌꯨꯅꯥꯏꯇꯦꯗ ꯁ꯭ꯇꯦꯇꯁꯇꯥ ꯂꯩꯕꯥ ꯑꯍꯜ ꯑꯣꯏꯔꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯒꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ 15%ꯗꯤ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩ ꯍꯥꯌꯅꯥ ꯄꯥꯅꯔꯤ꯫ ꯃꯈꯣꯌ ꯀꯌꯥꯗꯥ ꯔꯦꯅꯦꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯆꯥꯡ ꯈꯔꯥ ꯂꯩꯕꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯁꯔꯨꯒꯤ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯑꯁꯤ ꯀꯤꯗꯅꯤꯁꯤꯡ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯁꯣꯀꯍꯜꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ, ꯑꯃꯁꯨꯡ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯇꯧꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯍꯦꯟꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯔꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯒꯤ ꯐꯤꯚꯝ ꯑꯁꯤ ꯁ꯭ꯔꯤꯂꯉ꯭ꯀꯥꯗꯁꯨ ꯀꯃꯟ ꯑꯣꯏ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯃꯔꯃꯁꯤꯡ ꯀꯔꯤꯅꯣ?

ꯃꯔꯨꯑꯣꯏꯕꯥ ꯃꯔꯃꯗꯤ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ (CKD) . ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯅꯥ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯅꯒꯤ ꯆꯥꯡ ꯁꯣꯀꯍꯜꯂꯤ, ꯑꯃꯁꯨꯡ ꯕꯣꯟ ꯔꯤꯄꯦꯌꯥꯔ (bone turnover)ꯒꯤ ꯅꯣꯔꯃꯦꯜ ꯄ꯭ꯔꯣꯁꯦꯁ ꯑꯗꯨꯁꯨ ꯁꯣꯀꯍꯜꯂꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯅꯠꯠꯔꯒꯥ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯌꯥꯡꯅꯥ ꯄꯥꯌꯈꯠꯂꯕꯗꯤ, ꯑꯅꯤꯃꯛꯅꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯃꯔꯨꯑꯣꯏꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡꯗꯤ ꯁꯔꯨ ꯇꯥꯡ ꯁꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯁꯣꯀꯄꯥ ꯑꯁꯤꯅꯤ . ꯃꯤꯑꯣꯏ ꯈꯔꯗꯗꯤ ꯂꯥꯌꯅꯥ ꯑꯁꯤꯒꯤ ꯑꯍꯥꯅꯕꯥ ꯇꯥꯉ꯭ꯀꯛꯇꯥ ꯂꯥꯏꯑꯣꯡ ꯑꯃꯠꯇꯥ ꯎꯕꯥ ꯐꯪꯗꯕꯥ ꯌꯥꯏ꯫ ꯃꯗꯨ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯂꯥꯡꯇꯛꯅꯔꯤꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯅꯤ꯫

ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯅꯥ ꯅꯥꯕꯥ ꯅꯍꯥ ꯑꯣꯏꯔꯤꯕꯥ ꯑꯉꯥꯡꯁꯤꯡꯗꯥ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯒ꯭ꯔꯣꯊ ꯔꯤꯇꯥꯔꯗꯦꯁꯟ ꯂꯩꯕꯥ ꯌꯥꯏ꯫ ꯃꯈꯣꯌꯗꯥ ꯔꯤꯀꯦꯠ ꯀꯧꯕꯥ ꯕꯣꯟ ꯗꯤꯐꯣꯔꯃꯤꯇꯤꯁꯤꯡꯁꯨ ꯂꯥꯀꯄꯥ ꯌꯥꯏ . ꯔꯤꯀꯦꯠ ꯑꯁꯤ ꯑꯉꯥꯡ ꯑꯣꯏꯔꯤꯉꯩꯗꯥ ꯊꯣꯀꯄꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯃꯦꯂꯦꯁꯤꯌꯥꯒꯤ ꯃꯑꯣꯡ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯁꯔꯨꯁꯤꯡ ꯑꯗꯨ ꯇꯔꯨ-ꯇꯅꯥꯅꯕꯥ ꯑꯣꯏꯔꯀꯏ ꯑꯃꯁꯨꯡ ꯅꯃꯊꯕꯥ ꯌꯥꯏ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯈꯪꯗꯣꯀꯄꯒꯦ?

ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ, ꯅꯍꯥꯛꯀꯤ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯍꯤꯁ꯭ꯇꯔꯤꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯏꯃꯨꯡꯒꯤ ꯀꯅꯥꯒꯨꯝꯕꯥ ꯑꯃꯠꯇꯅꯥ ꯃꯥꯟꯅꯕꯥ ꯑꯅꯥꯕꯥ ꯂꯩꯔꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯆꯦꯀꯁꯤꯟꯅꯥ ꯇꯥꯒꯅꯤ꯫ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯃꯈꯣꯌꯅꯥ ꯐꯤꯖꯤꯀꯦꯜ ꯑꯦꯀꯖꯥꯃꯤꯅꯦꯁꯟ ꯑꯃꯥ ꯄꯥꯡꯊꯣꯛꯀꯅꯤ꯫

ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯑꯆꯨꯝꯕꯥ ꯃꯑꯣꯡꯗꯥ ꯈꯪꯗꯣꯛꯅꯕꯥ ꯁꯤꯖꯤꯟꯅꯔꯤꯕꯥ ꯇꯦꯁ꯭ꯠ ꯀꯌꯥ ꯂꯩꯔꯤ:

ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯠ: ꯃꯁꯤꯅꯥ ꯏꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ, ꯐꯣꯁꯐꯔꯁ, ꯚꯤꯇꯥꯃꯤꯟ D, ꯑꯃꯁꯨꯡ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫ ꯃꯈꯣꯌꯅꯥ ꯕꯣꯟ ꯇꯔꯅꯑꯣꯚꯔꯒꯤ ꯑꯇꯣꯞꯄꯥ ꯃꯥꯔꯀꯔꯁꯤꯡꯁꯨ ꯃꯥꯄꯂꯅꯤ, ꯃꯈꯣꯌꯁꯤꯡ ꯑꯗꯨꯗꯤ ꯑꯦꯂꯀꯥꯂꯥꯏꯟ ꯐꯣꯁꯐꯦꯇꯦꯖ . ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯏꯒꯤ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯑꯁꯤ ꯇꯧꯗꯨꯅꯥ ꯂꯦꯚꯦꯂꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯑꯍꯣꯡꯕꯥ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯒꯅꯤ꯫
ꯕꯣꯟ ꯕꯥꯏꯑꯣꯞꯁꯤ: ꯃꯁꯤꯗꯥ ꯁꯔꯨꯗꯒꯤ ꯇꯤꯁꯨꯒꯤ ꯑꯄꯤꯀꯄꯥ ꯁꯔꯨꯛ ꯑꯃꯥ ꯂꯧꯗꯨꯅꯥ ꯂꯦꯕ ꯑꯃꯗꯥ ꯇꯦꯁ꯭ꯠ ꯇꯧꯕꯥ ꯌꯥꯎꯏ꯫ ꯃꯁꯤꯅꯥ ꯁꯔꯨꯒꯤ ꯗꯦꯟꯁꯤꯇꯤ ꯑꯃꯁꯨꯡ ꯁ꯭ꯠꯔꯀꯆꯔꯒꯤ ꯑꯐꯕꯥ ꯋꯥꯈꯜꯂꯣꯟ ꯑꯃꯥ ꯄꯤꯕꯥ ꯉꯃꯒꯅꯤ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯇꯦꯁ꯭ꯠ ꯑꯃꯅꯤ꯫
ꯕꯣꯟ ꯗꯦꯟꯁꯤꯇꯤ ꯇꯦꯁ꯭ꯠ: DEXA scan ꯍꯥꯌꯅꯥꯁꯨ ꯀꯧꯏ, ꯃꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨꯁꯤꯡꯒꯤ ꯃꯄꯥꯉ꯭ꯒꯜ ꯑꯃꯁꯨꯡ ꯃꯈꯣꯌꯒꯤ ꯐ꯭ꯔꯦꯀꯆꯔꯒꯤ ꯔꯤꯁ꯭ꯛ ꯑꯗꯨ ꯂꯦꯄꯊꯣꯀꯏ꯫
ꯏꯃꯦꯖꯤꯡ ꯇꯦꯁ꯭ꯇꯁꯤꯡ: ꯑꯦꯛꯁ-ꯔꯦ , ꯁꯤ.ꯇꯤ.ꯁ꯭ꯀꯦꯟ , ꯑꯃꯁꯨꯡ ꯑꯦꯝ.ꯑꯥꯔ.ꯑꯥꯏ.ꯒꯨꯝꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡꯅꯥ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯑꯍꯣꯡꯕꯥ ꯂꯥꯀꯄꯥ ꯎꯕꯥ ꯐꯪꯏ꯫ ꯁꯤ.ꯇꯤ.ꯁ꯭ꯀꯦꯟ ꯑꯃꯁꯨꯡ ꯏꯀꯣꯀꯥꯔꯗꯤꯑꯣꯒ꯭ꯔꯥꯐ ( ꯍꯥꯔꯇꯀꯤ ꯁ꯭ꯀꯦꯟ ꯑꯃꯥ ) ꯑꯁꯤꯁꯨ ꯏꯒꯤ ꯈꯣꯡꯖꯦꯂꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯗꯤꯄꯣꯖꯤꯠ (ꯀꯦꯂꯁꯤꯐꯤꯀꯦꯁꯟ) ꯌꯦꯡꯕꯗꯥ ꯁꯤꯖꯤꯟꯅꯩ꯫

ꯅꯤꯡꯁꯤꯡꯕꯤꯌꯨ, ꯃꯤꯄꯨꯝ ꯈꯨꯗꯤꯡꯃꯛꯅꯥ ꯇꯦꯁ꯭ꯠ ꯄꯨꯝꯅꯃꯛ ꯑꯁꯤ ꯇꯧꯕꯒꯤ ꯃꯊꯧ ꯇꯥꯗꯦ꯫ ꯅꯍꯥꯛꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨꯗꯥ ꯌꯨꯝꯐꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯀꯔꯤ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯃꯊꯧ ꯇꯥꯕꯒꯦ ꯍꯥꯌꯕꯗꯨ ꯂꯦꯄꯀꯅꯤ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯅꯍꯥꯛꯅꯥ ꯐꯪꯂꯤꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯑꯁꯤ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯀꯌꯥ ꯌꯥꯝꯅꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯍꯅꯕꯒꯦ, ꯅꯍꯥꯛꯀꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯒꯤ ꯁ꯭ꯇꯦꯖ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯅꯠꯠꯔꯒꯥ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯁꯣꯟꯊꯔꯀꯄꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯂꯥꯏꯌꯦꯡꯒꯤ ꯑꯣꯄꯁꯟ ꯀꯌꯥ ꯂꯩ:

ꯗꯥꯏꯇꯇꯥ ꯑꯍꯣꯡꯕꯥ ꯂꯥꯀꯄꯥ: ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯐꯣꯁꯐꯔꯁ ꯅꯦꯝꯕꯥ ꯗꯥꯏꯠ ꯑꯃꯥ ꯔꯤꯀꯃꯦꯟꯗ ꯇꯧꯕꯥ ꯌꯥꯏ . ꯃꯁꯤꯅꯥ ꯐꯣꯁꯐꯔꯁ ꯌꯥꯝꯅꯥ ꯌꯥꯎꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡ (ꯄ꯭ꯔꯣꯁꯦꯁ ꯇꯧꯔꯕꯥ ꯑꯃꯁꯨꯡ ꯄꯦꯀꯦꯠ ꯇꯧꯔꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡ) - ꯍꯥꯌꯕꯗꯤ ꯀꯦꯟꯗꯜ ꯑꯣꯏꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡ, ꯏꯅꯁ꯭ꯇꯦꯟꯇ ꯅꯨꯡꯁꯥ, ꯑꯃꯁꯨꯡ ꯁꯁꯦꯖꯁꯤꯡ ꯑꯁꯤ ꯂꯤꯃꯤꯠ ꯇꯧꯕꯥ ꯍꯥꯌꯕꯁꯤꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ, ꯅꯍꯥꯛꯅꯥ ꯃꯍꯧꯁꯥꯅꯥ ꯐꯣꯁꯐꯔꯁ ꯌꯥꯝꯅꯥ ꯌꯥꯎꯕꯥ ꯆꯤꯟꯖꯥꯀꯁꯤꯡ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯗꯥꯏꯔꯤꯒꯤ ꯄꯣꯠꯊꯣꯛ ꯈꯔꯗꯤ, ꯅꯠ, ꯑꯃꯁꯨꯡ ꯑꯀꯪꯕꯥ ꯃꯅꯥ-ꯃꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯉꯥ) ꯂꯤꯃꯤꯠ ꯇꯧꯕꯁꯨ ꯃꯊꯧ ꯇꯥꯕꯥ ꯌꯥꯏ꯫
ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯁꯞꯂꯤꯃꯦꯟꯇꯁꯤꯡ: ꯃꯁꯤꯅꯥ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯅꯒꯤ ꯆꯥꯡ ꯑꯗꯨ ꯕꯦꯂꯦꯟꯁ ꯇꯧꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯀꯦꯂꯁꯤꯌꯝ ꯑꯃꯁꯨꯡ ꯚꯤꯇꯥꯃꯤꯟ D ꯁꯞꯂꯤꯃꯦꯟꯇꯁꯤꯡ, ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯍꯣꯔꯃꯣꯟ (PTH)ꯒꯤ ꯆꯥꯡ ꯍꯟꯊꯍꯅꯕꯥ ꯍꯤꯗꯥꯀꯁꯤꯡ, ꯑꯃꯁꯨꯡ ꯐꯣꯁꯐꯔꯁ ꯕꯥꯏꯟꯗꯔꯁꯤꯡ ꯄꯤꯕꯥ ꯌꯥꯏ꯫ ꯍꯧꯖꯤꯛꯇꯤ ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯑꯌꯥꯝꯕꯅꯥ ꯅꯟ-ꯀꯦꯂꯁꯤꯌꯝ ꯐꯣꯁꯐꯔꯁ ꯕꯥꯏꯟꯗꯔꯁꯤꯡ ꯔꯤꯀꯃꯦꯟꯗ ꯇꯧꯔꯤ ꯃꯔꯃꯗꯤ ꯀꯦꯂꯁꯤꯌꯝ ꯌꯥꯝꯅꯥ ꯌꯥꯑꯣꯕꯅꯥ ꯑꯦꯗꯥꯏꯅꯥꯃꯤꯛ ꯕꯣꯟ ꯗꯤꯖꯤꯖ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫
ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯁꯔꯖꯔꯤ: ꯀꯔꯤꯒꯨꯝꯕꯥ ꯑꯇꯩ ꯂꯥꯏꯌꯦꯡꯁꯤꯡꯅꯥ ꯊꯕꯛ ꯇꯧꯗ꯭ꯔꯕꯗꯤ ꯁꯔꯖꯔꯤ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯌꯥꯏ꯫ ꯃꯁꯤꯗꯥ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯒ꯭ꯜꯌꯥꯟꯗ ꯑꯃꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯃꯗꯒꯤ ꯍꯦꯅꯕꯥ ꯂꯧꯊꯣꯀꯄꯥ ꯌꯥꯎꯏ꯫ ꯃꯁꯤꯕꯨ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗꯦꯛꯇꯣꯃꯤ ꯍꯥꯌꯅꯥ ꯀꯧꯏ . ꯃꯍꯧꯁꯥꯅꯥ, ꯌꯥꯃꯗ꯭ꯔꯕꯗꯥ ꯄꯦꯔꯥꯊꯥꯏꯔꯣꯏꯗ ꯒ꯭ꯜꯌꯥꯟꯗ ꯑꯃꯥ ꯊꯃꯖꯤꯜꯂꯤ꯫ ꯃꯁꯤꯅꯥ ꯄꯤ.ꯇꯤ.ꯑꯩꯆ.ꯒꯤ ꯆꯥꯡ ꯌꯥꯝꯅꯥ ꯍꯟꯊꯕꯥ ꯑꯃꯁꯨꯡ ꯑꯦꯅꯥꯅꯥꯃꯤꯛ ꯕꯣꯟ ꯗꯤꯖꯤꯖ ꯊꯣꯀꯍꯅꯕꯥ ꯊꯤꯡꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯃꯁꯤ ꯄꯨꯝꯅꯃꯛ ꯑꯁꯤꯒꯤ ꯃꯊꯛꯇꯥ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯗꯨ ꯃꯦꯅꯦꯖ ꯇꯧꯕꯗꯁꯨ ꯃꯇꯦꯡ ꯄꯥꯡꯒꯅꯤ꯫ ꯂꯥꯏꯌꯦꯡꯕꯒꯤ ꯄ꯭ꯂꯥꯟ ꯑꯗꯨ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯏꯅꯕꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯃꯈꯥ ꯇꯥꯅꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯑꯁꯤ ꯊꯤꯡꯕꯥ ꯉꯃꯒꯗ꯭ꯔꯥ?

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯊꯤꯡꯕꯗꯥ ꯑꯋꯥꯕꯥ ꯑꯣꯏ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ (CKD) ꯑꯁꯤ ꯐꯖꯅꯥ ꯃꯦꯅꯦꯖ ꯇꯧꯕꯅꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯥ ꯉꯝꯃꯤ ꯑꯃꯁꯨꯡ ꯃꯁꯤꯒꯤ ꯄ꯭ꯔꯣꯒ꯭ꯔꯦꯁ ꯑꯁꯤ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯍꯦꯅꯒꯠꯂꯀꯏ꯫. ꯍꯥꯌꯕꯗꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯄꯤꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯗꯨ ꯃꯇꯝ ꯆꯥꯅꯥ ꯂꯧꯕꯥ, ꯄꯤꯔꯤꯕꯥ ꯗꯥꯏꯠ ꯑꯗꯨ ꯉꯥꯛꯅꯥ ꯆꯠꯄꯥ, ꯑꯃꯁꯨꯡ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁꯀꯤ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯑꯦꯛꯁꯔꯁꯥꯏꯖ ꯇꯧꯕꯥ, ꯃꯩꯈꯨ ꯊꯥꯗꯣꯀꯄꯥ ꯊꯤꯡꯕꯥ ꯑꯃꯁꯨꯡ ꯌꯨ ꯊꯀꯄꯥ ꯌꯥꯗꯕꯅꯁꯨ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯃꯅꯥ ꯀꯔꯤ ꯑꯥꯁꯥ ꯇꯧꯕꯥ ꯌꯥꯕꯒꯦ?

ꯀꯤꯗꯅꯤ ꯇ꯭ꯔꯥꯟꯁꯞꯂꯥꯟꯇ ꯅꯠꯇꯅꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤꯒꯤ ꯃꯇꯝ ꯆꯨꯞꯄꯒꯤ ꯑꯣꯏꯕꯥ ꯂꯥꯌꯦꯡ ꯑꯃꯠꯇꯥ ꯂꯩꯇꯦ . ꯃꯇꯝ ꯁꯥꯡꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯅꯥ ꯅꯥꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯐꯉ꯭ꯀꯁꯟ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯍꯟꯊꯔꯀꯏ꯫ ꯃꯤꯑꯣꯏ ꯀꯌꯥꯅꯥ ꯑꯔꯣꯏꯕꯗꯥ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯀꯤꯗꯅꯤ ꯐꯦꯜ ꯑꯣꯏꯔꯀꯏ ꯑꯃꯁꯨꯡ ꯗꯥꯏꯑꯦꯂꯥꯏꯁꯤꯁ ꯃꯊꯧ ꯇꯥꯏ꯫ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯑꯁꯤ ꯊꯧꯑꯣꯡ ꯑꯁꯤꯒꯤ ꯀꯃꯟ ꯑꯣꯏꯕꯥ ꯀꯃꯞꯂꯤꯀꯦꯁꯟ ꯑꯃꯅꯤ꯫

ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏ ꯀꯌꯥꯗꯁꯨ ꯍꯥꯔꯇꯀꯤ ꯂꯥꯌꯅꯥ ꯂꯥꯀꯏ꯫ ꯍꯥꯔꯇꯀꯤ ꯂꯥꯌꯅꯥ ꯑꯁꯤꯅꯥ ꯀꯤꯗꯅꯤ ꯐꯦꯜ ꯑꯣꯏꯔꯀꯄꯗꯒꯤ ꯑꯌꯥꯝꯕꯥ ꯁꯤꯕꯒꯤ ꯃꯔꯝ ꯑꯣꯏꯔꯤ꯫

ꯑꯗꯨꯕꯨ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯃꯤꯅꯔꯦꯜ ꯑꯃꯁꯨꯡ ꯍꯣꯔꯃꯣꯅꯒꯤ ꯆꯥꯡ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯅꯤ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯑꯃꯁꯨꯡ ꯊꯝꯃꯣꯌꯕꯨ ꯉꯥꯀꯊꯣꯛꯅꯕꯥ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯔꯤꯀꯃꯦꯟꯗ ꯇꯧꯒꯅꯤ꯫

ꯅꯍꯥꯛꯅꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯀꯗꯥꯏꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯒꯗꯒꯦ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ (CKD) ꯂꯩꯔꯕꯗꯤ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯁꯔꯨ ꯇꯥꯡ ꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯁꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯈꯪꯍꯅꯕꯤꯌꯨ . ꯃꯁꯤ ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯈꯨꯗꯝ ꯑꯃꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫

ꯃꯤꯑꯣꯏ ꯀꯌꯥꯅꯥ ꯃꯈꯣꯌꯗꯥ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯔꯦ ꯍꯥꯌꯕꯥ ꯈꯪꯂꯀꯏ, ꯃꯗꯨ ꯍꯥꯟꯅꯗꯒꯤ ꯍꯦꯟꯅꯥ ꯆꯥꯎꯈꯠꯂꯛꯂꯕꯥ ꯃꯇꯃꯗꯥ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯆꯦꯀꯑꯞ ꯇꯧꯕꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯉꯟꯅꯥ ꯈꯉꯗꯣꯀꯄꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯕꯥ ꯉꯃꯒꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯗꯨ ꯑꯣꯏꯔꯕꯗꯤ, ꯅꯍꯥꯛꯅꯥ ꯃꯗꯨ ꯍꯦꯟꯅꯥ ꯐꯠꯆꯤꯜꯂꯛꯇꯅꯕꯥ ꯈꯣꯡꯊꯥꯡ ꯂꯧꯈꯠꯄꯥ ꯌꯥꯏ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥꯒꯤ ꯔꯤꯁ꯭ꯛ ꯐꯦꯛꯇꯔ ꯑꯃꯥ ꯂꯩꯔꯕꯗꯤ (ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯑꯔꯨꯝꯕꯥ ꯍꯦꯅꯕꯥ, ꯗꯥꯏꯑꯦꯕꯦꯇꯤꯖ ꯂꯩꯕꯥ, ꯏꯃꯨꯡ-ꯃꯅꯨꯡꯗꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ, ꯍꯥꯔꯇꯀꯤ ꯂꯥꯌꯅꯥ, ꯅꯠꯠꯔꯒꯥ ꯍꯥꯏ ꯕ꯭ꯂꯗ ꯄ꯭ꯔꯦꯁꯔ ꯂꯩꯕꯥ) ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯇꯦꯛ-ꯍꯣꯝ ꯃꯦꯁꯦꯖ ꯇꯧꯕꯥ꯫

ꯑꯣꯀꯦ, ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯋꯥꯔꯤ ꯁꯥꯈꯤꯕꯥ ꯑꯗꯨꯗꯒꯤ ꯅꯍꯥꯛꯅꯥ ꯅꯤꯡꯁꯤꯡꯒꯗꯕꯥ ꯋꯥꯐꯝ ꯈꯔꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯦꯃꯗꯣꯀꯆꯁꯤ:

ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤ ꯍꯥꯌꯕꯁꯤ ꯀ꯭ꯔꯣꯅꯤꯛ ꯀꯤꯗꯅꯤ ꯗꯤꯖꯤꯖ (CKD)ꯅꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯁꯔꯨꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯃꯅꯤ꯫
ꯀꯤꯗꯅꯤꯁꯤꯡꯅꯥ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯊꯕꯛ ꯇꯧꯗꯕꯥ ꯃꯇꯃꯗꯥ, ꯏꯗꯥ ꯌꯥꯎꯔꯤꯕꯥ ꯀꯦꯂꯁꯤꯌꯝ, ꯐꯣꯁꯐꯔꯁ ꯑꯃꯁꯨꯡ ꯚꯤꯇꯥꯃꯤꯟ Dꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯆꯥꯡ ꯃꯥꯟꯅꯗꯕꯥ ꯑꯣꯏꯔꯀꯏ, ꯑꯃꯁꯨꯡ ꯁꯔꯨꯁꯤꯡ ꯑꯁꯤ ꯁꯣꯟꯊꯔꯀꯄꯥ ꯌꯥꯏ꯫
ꯁꯔꯨ ꯇꯥꯡ ꯁꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯁꯣꯛ-ꯄꯅꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡꯅꯤ, ꯑꯗꯨꯕꯨ ꯑꯍꯥꯅꯕꯗꯥ ꯂꯥꯏꯑꯣꯡ ꯑꯃꯠꯇꯥ ꯂꯩꯔꯃꯗꯕꯥ ꯌꯥꯏ꯫
ꯗꯣꯛꯇꯔꯁꯤꯡꯅꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯠ ꯑꯃꯁꯨꯡ ꯁ꯭ꯀꯦꯅꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯈꯪꯗꯣꯀꯏ꯫
ꯂꯥꯏꯌꯦꯡꯕꯗꯥ ꯗꯥꯏꯠ ꯀꯟꯠꯔꯣꯜ, ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯁꯔꯖꯔꯤꯁꯤꯡ ꯌꯥꯎꯏ꯫
ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯅꯕꯒꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯄꯥꯝꯕꯩꯗꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯁꯤ ꯐꯖꯅꯥ ꯃꯦꯅꯦꯖ ꯇꯧꯕꯅꯤ꯫
ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯔꯕꯗꯤ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯊꯣꯛꯂꯕꯗꯤ ꯈꯨꯗꯛꯇꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯒꯥ ꯇꯥꯟꯅꯧ꯫
ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯆꯦꯀꯑꯄꯁꯤꯡꯅꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯇꯣꯏꯅꯥ ꯈꯪꯗꯣꯀꯄꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫

ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯐꯍꯅꯕꯥ ꯉꯃꯗ꯭ꯔꯕꯁꯨ, ꯃꯇꯤꯛ ꯆꯥꯕꯥ ꯂꯥꯏꯌꯦꯡ ꯑꯃꯁꯨꯡ ꯃꯦꯗꯤꯀꯦꯂꯒꯤ ꯄꯥꯎꯇꯥꯀꯁꯤꯡ ꯉꯥꯛꯅꯥ ꯆꯠꯄꯅꯥ, ꯅꯍꯥꯛꯅꯥ ꯄꯨꯟꯁꯤꯒꯤ ꯑꯐꯕꯥ ꯃꯒꯨꯟ ꯑꯃꯥ ꯊꯝꯕꯥ ꯉꯃꯒꯅꯤ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏꯗꯕꯅꯤ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯥ ꯋꯥꯔꯤ ꯁꯥꯟꯅꯧ ꯑꯃꯁꯨꯡ ꯃꯊꯧ ꯇꯥꯕꯥ ꯊꯕꯀꯁꯤꯡ ꯄꯥꯡꯊꯣꯀꯎ꯫

ꯅꯍꯥꯛꯀꯤ ꯀꯤꯗꯅꯤꯒꯤ ꯄ꯭ꯔꯣꯕ꯭ꯂꯦꯃꯁꯤꯡꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯁꯔꯨ ꯇꯥꯡꯁꯤꯡꯗꯥ ꯁꯣꯀꯍꯅꯕꯥ ꯌꯥꯕ꯭ꯔꯥ? ꯔꯦꯅꯥꯜ ꯑꯣꯁ꯭ꯇꯤꯑꯣꯗꯤꯁ꯭ꯠꯔꯣꯐꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯉꯂꯁꯤ!