15  years old female pateit 
bilateral puuv

wbc  3.2   hgb10    plt268
she is knonw to have multiple  comodbidies 
she has   multiple  urology  problem 

creatiine   5.6 
k  5.5 
  She   was  followed by dr  mutasem duodin 
best  creatiine  level  3.2 
highest  level    5,6 


creatinine  5.6   bun   39
urine analysis showed     wbc  2-8    protein =2
crp  2.8
na  143   k 5.4  cl 118


plan 
add   calcium 
alfa
sodium bicarbonate
mepral


medication 
off  medication  except  for   key exylate