41   years old male pt 
hypertension for the alst  2  years 

hypertension  in the family 
dl   dm 
no family history   for  ckd 
he has  joint pain and  morning  stiffness 

he has  morning   stiffness 

he has  skin rash 

urine analysis shoed   protein  =2  and     erythrocyte   10 
microalbuminemia  300 
echo    negative 
renal  doppler   decrease velivicity 
cta       normal

impression  
iga nephropathy 
ct   angio   for  the  aorta  normal 
renal doppler  normal 