50  years old male pt 
known to have  small kindneys and hypertension 

Medications 
concor 
amici  
alfacal 
lloril
omnic 
spirin 
methyldopa 
sodium bicarbonate 
parathyroid scan showed  parathyroid  adenoma in the mid  zone 
discopathy   l3l4lll4l5llll5s1 


labs  in  2/2025  showed 
creatinine  3.9 
bun  51 
albumin 4.6
ldl  70 
k  4.9 
hgba1c  5.7
na  140 
wbc  8,4    hgb   11.9 plt  218
calciumm 9.7 
esr  35
prolactin    14       tsh    4,1 
urine analysis  showed  no  protein  and no  rbc 
creatinine  trend  showed    1/2025    5,5   
3/11/2024    3,6 

PLAN 
ADD SODIUM BICARBONATE 
KEEP THE SAME RX 
RTC AFTER ONE MONTH 
LL INSTRUCTION WERE GIVEN 