69   years old male pateint 
known to have DM for the last   20  years  with retinopathy  
hypertension for the last   20 years 
dld 
no ischemic ehart disease 


is  creatinine   reached   5.3 
and then it  is  3.5 mg ocne 

medications 
iron supp
cadex  2mg 
lokwlma  5 mg once 
lantus   8  iu
alfacal 0.25 mg once 
repaglinide   0.5 mg ocne 
simvastatin    20 iu 
b12   once daily 

creatinine   4.8 
urea     229
potassium  5,4 
sodium   139 
phosphoric    4.7 
calciuj m   8.7
alakaline phosphoatase     65 
ast    10 
alt   10 
t  protein      6.3
albumin   3,6
globin   2.6


pLAN 
ADD  AMIOCOR  5MG  1X1 
ADD  CADEX  2 MG OCNE 
SODIUM  BICARBONATE 
ADD  BIOSOLVE 
MAKE ALFACAL 0.25  EOD 
ADD  CALCIUM 

REASSESSSMENT AFTER LABD AND  ABDOMINAL US 
