36  years old male pt 
he has  blood pressure    more than 200/100 
he was  evalauted at alia hospital   by  ramadan   and others at hebron govermental hospital 
he found  to have proteinuria

he has  itching    since  ramadan 

medication 
valsadipin 160/10/25  once daily 

no joint pain 
no  oral ulceration 
no family hsotory for kdiney disease 
he has  family history for rheumatic  disease 

plan 


do labs 
add  cvarvidelol since his  blood  pressure    160/10 
abdominal us 
labs   and then reevalaution 