38    years old male 
23/4  he was admitted to   halhul hospitl  asa case   of  chest pain since morning 
he  found to have  blood presusre  195/137 

creatiien  2.4 
he was admischaged on nifidipin and   alfacal  with calciu     and  arvidelol   6.25 mg 1x2 

abdominal us  was done and showed  both kidney  iocrase  echogenecity    with loss of  cortical thickkness and   signs of  renalimpatient  

the right kdiney   10  cm and the  left kdieny  11  cm


echo was done and showed  noral   reginoal and  global   a nd no   hypokineia 
  mild concentric      lvh  
mild    diastolic  dysfunction 

ophthalomology consutlation  shwoed   hypertensii   retinopathy


26/3   creatinine   2.2  
albumin /creatinine  ration     924
ana  and  anti  dn a   negative
creatinine  1/4   1.7
esr   50
c3  c4   normal
urien  pcr    less than   500   at hebron geoverminal hospital
renin  /aldastron levek     19


medication 
he is on  nifidipin  60 mg 1x2 
carvdelol  6,25 mg 1x2 
empa  10 mg ocne 
cadex  4 mg ocne 



add  aclium 
add   alfacal 
rtc after 2 weeks 