52    years old female pt 
dm  for the laast    25  years 
htn 
gout 
dld 
ihd 
sojgren syndrom 

presented with  proteinuria  
creatinien  1,1   to  1,5  for the alst   3  months   but lasat  year  it was   trace  proteinuria and creatinine of 0,8 

she has  poor   neurological  manfistation 
eye  prolnel   rigth  eye  blidness and left  eye   major impairement 


aldactone   25 
mepral   20 mg once 
inflicta  10 mg once 
sitaglu   met   50/850 
insulin apidra and lantus 
valvorg  160/10 
asa  100 mg once 
crestor   20 mg ocne 
cadex    2 mg once 
miro 

plan 
stop aldactone 
add   kerendia 
add   ferroud  fumarate 
add  flatex 

rtc after one month