68   years old male patent
known to have dm for the last  6  yearS 
Hypertension   
dLD  not on treatement 

he  suffered from left kidney stone and    it passed   alone 

labs showed   creatinine  was  high 
medication 
amaryl  4 mg once  daily 

metformin 
sitaglu 

a1c 6,5 

he is    onalloril    100 mg ocne  daily 


creatinine  2.7 
bun    35
urine analysis   showed   neagtive  for  uti 


plan 
add   cadex since his blood pressure   160/70   
ad   biosoleve 
add betastin 

rtc after  3 weeks 
with  kidney functiont est and serum electroltyes and  urine protein /creatinine ratio