73   years  old male Patient 
known to have   DM  for the    25  years 
Hypertension  for the last  25 
dld 
ischemic heart disease    with stent 
chronic Kidney disease with Base  line  more than 2 
he had   renal stone  many years ago and he has  


medication 
atacand    16  
cadex   4 mg once 
insulin  mixtard  
asa  100 mg ocne 
lipitor   40 mg once 


his base line creatinien  3,2    and  he came with creatinine  4.3 

plan
stop atacan 
add amicor   1x1 
make cadex  4 mg 1x2 
add calcium   600 mg once 
alfacal o,25 m
g ocne 
mepral  20 mg once 

rtc after   3weeks 
