63   years 
male pt 
known to have 
DM X   13 
HTN  X  18 
DLD   X 
IHD   Before   2  years and  before  4   years 


presented with   high creatinne    1.8 mg/dl 
after ramadain  it  was  1,5   and  1,7 


medications 
nexium  20 mg once 
janeut  
amaryl
tritace com   5/25
amicor 
inflicta
amaryl 2 
alloril
concor
janeut 
lipitor 
plavix 
xartal 
muscol 


plan 
add   cadex 
add  calcium 
add  alfacal 
do  renal us  with pre and post  voing  assessment 
please   repeat the test after one mont 

rtc after  doing the lasb