42   yers old female pateint 
before  2  years       she started to lose  weight   rapidely  from  95   to 65   over 
few  month 
she  found to have    gastric  problem 

investigation was  done and she    found to have creatinine  3  abd more  and on imaging   
the kidneys  are  small 

before   2  months  creatinine     4 
for the last  2  weeks she started to have       wer limbs edema and  she  has pain 


family history  for kidney  problem  with   2  brothers   has  kidney tx 
she  is  sister  for  dua3  abu aam3a 
mariam     her  mother with   end stag  kidney disease 

medicatoins 
lasix    40 mg   2x2 
nifidilong    30 mg 1x2 
alloril  100 mg once 


plan 
add  sodium bicarboante 
add   biosolve 
carvidelol   12,5 mg 1x2 
cadex    4 mg  1x2
mepral  20 mg once 

