77  years  old male 
knonw to have DM HTN   CHF   
STENT   BEFORE   30 YEARS 
bPH


creatinine  1.4 
urine analysis  +2  protein 
ldl  target 

bp  160/90

abdominal us    showed    few  bilateral  cotrical cyst on the right side 
about  8 mm      left kidney   stone  

right kindey  12 
left kidney   12.5 

cortical thickness    1.3-1.5 
normal  urine bladder 
prevoiding   255 ml 'post  voiding    60  cc  residual 

enlarged  prostat 

preented with    with lower limbs  edema 
medication 
asa   100 mg once 
lipitor  40 mg once 
metformin   
omnic 


plan 4stop exfor  
add  diovan 
add   cadex 
add  empa 
add  galvus 
stop  sitaglumet 


rtc afer one month 
do  renal and prostat  us 