ام مجدي 
64    years old   female 
DM    A1C  6.5,    For the last  10 years
HTN    10  years 
DLD 


CKD   Base line creatinine 2.4 

Medications
Semglee   12  pm  and  20  am 
Apidra   16  before  each meal
L -carnitine
Crestor
Oracal
Amicor  1x2
Asa  100 mg once 
Carvidelol  12.5  x2 

Uric  acid  9
Ast and alt  normal 
Calciu,  89.3

Troponin  normal 
Cholesterol
Cholesterol  260 


Plan 
Add  sodium bicarbonate    500   1x1 
Add  j  dee 
Alfacal  0.25 mcg 
Add alloril 
Do  tsh-
\

  today she came  for  follow up 
creatinine  3.56 
bun 30 
hgb  12.8 
urine analysis shwoed   positive nitricte and   many  wbc 
ldl   1888  but she was taking  wrong  medication 

plan