18   years old male pt on menirine 



today he was seen and his chart was reviewed 
he had  creatinine  1.7  to  1.9 

renal us  shwoed  increase  renal echogenecity 
urine analyssi showed   no  protein   a nd  no  blood 

plan 
do  creatinine and    do urien  pcr 

toda creatine 1,6

plan 
kidney  biopsyu   referral  this  thursday 
add  minirin  melt   120 mg   for  enuresis 
further work up  for  spleenomegaly 
consider referral  for  urodynamic stday  if no improvement on  minirin

