today  the pateint   was seen and her  chart was reviewed 
she looks  better 
hgb    10   wbc  6   plt  242 
esr  47 
protein /creatinine ratio   4890 
albumin 3 
creatnine   1.24 
c3   0.57  from 0.58 
c4  1  fro0.1  from 0,08 
urine analysis  swoed protreinuria and hematuria 

plan 
make prednisone  25 mg     for  2 weeks 
then 20 mg  once 
add lasix    40 mg prn 
follow up  blood pressure
add iron 
add lasix  prn 
referral to alnahjah hospital 
rtc after one month
