he has kidney biopsy  one year ago   with no benifite 
he was seen by dr muhammad  albourini  but  didnot   do the biopsy 
then he  sought medical  advice   at jordan where  he underwent kidney biopsy  at  jordan 10/2023  21   glomeruli was   see  onne of then scelerosed   . it has  fibrocelluer crescent   , there is  diffue  glomeruler  mesangial   widening  with  increase mesangial cellularity   and  focal endocapillary   proliferation  
igg   negative    w
iga   +3    igm  +3    c3  positive    c4   +   kappa   and lambda   posiitve 
ig a  nephropathy   vesus  lupus 

another  kidney biopsy was done 

medications 
nexium
calcium
myfortic  2x2  
plaquenil   200 mg once 
atacand     16 mg once 
prednisone  20 mg once 
jardiance    10 mg once 
nexium 
dee   dense 

last  labs  showed 

10/2024   
creatinine2.1
c3  81  cr  23
hba1c  5.5
pcr   4000


plan 
on sutaterday tlo