93   years old female pt 
known to have  dld 

presented with rise in creatinine 1.9   increased to 2.3 

medication 
empa    10 mg once 
contraloc 
alfacal 
concor  5 mg once 
juvista 
amoxiclave 
lasix 

cinelone 

  stop alloril 
stop liponil stop empa 
stop  sitaglu 
add  deflazacort 
abdoinal us 
repeat the last   after one month 