65   yersold female pateint 
DM   FOR THE ALST   10 YEARS 
HTN  FOR THE ALST   10  YEARS 
DLD 
GOUT  


PRESENTED  FOR   FOLLOW UP   REFARIIG  THE PROTEINURIA 

CREATININE  1.2 
BURIC   8.9
PROTEIN /CREATIINE  RATIO    2745

MEDICATION 

VASADIPIN  HCT   160/25
ROSU
LIP  20 MG ONCE 



PLAN
FILRINON 
STOP  EMPA 
ADD  ADCEF 
ASA 
ROSLUPIL
ADCEF  EUXREASE 
RTC AFTER   1  MONTH
EUXREASE   50/1000
EMPA   10 MG ONCE 