75 years old male pt 
knonw to have  HTN      since long period of time 
BPH    with creatinine   4    due to obstructive uropathy    and then   he had another   obstructive  uropathy 
   1,7  mg/dl    

he  was referred frpm  dr izat    for  possible c cath as  he has  ckd  with base ine creatinine  1.7

medications 
LIPITOR 
ALDACTONE 
VALSADIPINE 
LASIX 
CADEX 
ASA 
VITAMINS 


labs  from  15/3    wbc   7  hgb  16   plt  206
alkal   82 
creatinine  1.58
creatinine   1.36


echo  showed 
LV      Showed    65%
no  RWMA 
MILD  CONCENTRIC LVH
NO PERICARDIAL EFFUSION 
NO PULMONARY  HTN 

PLAN 
ADD  NORVASC 
add  biosolve 
add  dee dense 
add co zic