for the last   2 month he has  bilateal  calf pain and   gneralzied weakness 
he has refractory pain  on the thigh , 
he sought medical advice at vasculer  surgery and it was unremarkable  by dr amar 

he has   itching for the last   2  motnhs 
he has  fatigue   for the last  2 months 
no previous  knonw  medical hiostory 
no family hisotiry 

he  has nocturia   for the last   3  months 
he is  driking alot of fluid 
no lower limb edema 
no hematuria 
no  proteinuria 


for  which he  found to have high  creatinine level 


abdominal us showed 
liver  normal 
normal  biliary  system 
gall blader  normal 
right kidney  small  on size 7.3  cm  7.8  in cortical thickness 
left kidney   8,8  cm    with 7.8  in cortical thickness 
no remal stone or mass 
other  organ are normal 

creatinine out side the hospital shwoed   5.9 
bun   67

in the hospital   labs  showed   bun 77
uroic  acid   6.8 
albumin 3.6 
phosphate  5.8
creatinine   7.2 
cholesterlol,  319 
iron 99 
ldl  151 
k 4.4 
calcium 7.3 
tibc217
sodium  137
mg  2.2 
wbc 8  hgb10,6  plt 585   mcv 94
esr  100
tsh 1.1 
ferritin 99
