58   Years  old male pt 
known to have  
hypertension for   since  2013 
gout   2013 
ischemic    heart disease   in 2015  wirg balooning 

stone former 
the had   right nephrectomy and then   lithotripsy  and many  jdj    an  dremoval on the left side 


he had  ad=bdominal us  that showed    status post  right side   nephrectomy   11/2023
and   he has  left    sided  hydrouretronephrosis   is  noted without     dilatation  of the    renal pelvix  oor    the ureter   otherwise   the left kidney  appears  normal    in shape and position  without  evidance of   focal elasion 
few    tiny stone seen  in the lower pole  of  the ledt kidney up  to 0.7   cm



6/2024   shwoe creatinine  1.5 
creatinine  in    30/6  showed   1.7
creatinine   29/6/2025    creatinine    2.2


medications 
atacabd plus 
alloril 
omnic 0.4


plan
do ca  po4   creatinine   serum lyte 
make  atacand plus      atacand  and  cadex 
add biosolve  
rtc after  3  weeks 