73  years old male patient 
known to have chronic kdiney disease and they asked  to do c cath  and   then he  found to have  creatinine    high 

dm for the last 20 years   or  more 
htn for the last   30 years 
dld 
gouty arthitis 
creatinine   reached  3.3    then  2.2   1.9 


20  ramadan  he    suffered from   myocardial ifarction and  he lased for more than one week 

after eid  he was  dmitted to  ccu as a case of   myocardial infaction and he needed dialysis   3  times   and then improved 

base line creatinine  2   and more 
Signifiant  BPH 

THE INDICATION FOR DIALYSIS WAS    VOLUME OVERLADED 

MEDICATION 

QUEST  2.5 MG 1X2
AMICOR 5MG ONCE
LIPONIL    40 MG ONCE
ALFACAL 0.35 MG ONCE 
ASA   100 MG ONCE
HYPOCOR  5 MG ONCE
CALCIUM 600 MG 
DEMATOR  20 MG ONCE 
DULOU  5 MG ONCE
CIPRALEX 
CADEX  4 MG ONCE 
INSULIN  
LANTUS   20 
APIDRA  20 PM 


PLAN 
ADD   BIOSOLVE 
ADD DEFLAZACORT 
ADD DOUDART 
RTC AFTER  2 WEEKS 
ADD ARANSP 