  62  years  old female pt 
anexity 
fibromyalgia 
DM   x10.5 
RF   positive 



since long period  of time 

she was referred  from nephrology  evalaution 
esr   28
  Urine PCR   179/35
RF  POSTIVE 
ANTI CCP    119
ALBUMIN   3.7 
BUN  12
K    5 
ALT     21 
AST      27 
NA  138
PROTEIN   6.6 
URIC    ACID    4.3
TSH  2.2
FERRITIN   64
MICROALBUIN  157
\C3   153
C4  29
WBC     6.1   HGB      15   PLT       269
CREATININE   1.05
GLUCONSE    291

ABDOMINAL US FEW   RENAL GRAVOL 
BOTH  KIDNEYA RE NORMAL


MEDICATIONS 
NERVANTIN   300 MG ONCE 
VIAPAX 150 MG ONCE 
ASPIRIN 
RUVAR    20 MG ONCE     FOR THE LAST  ONE WEEK 
COXIB   200 MG ONCE DAILY 
NEXIUM 40 MG ONCE 
GLYXAMBI    10/5 MG ONCE 
METFORMIN    500 MG ONCE 
AMARYL   2  MG ONE 

ADD   DIOVAN 
ADD  FORXIGA 

DO CREATINIE   IN 10/2 
RTC  IN  25/2    FOR    REEVALAUTION OF  THE  REPEATING   THE ALBUMINURIA 