59   years  
DM   X 13  YEARS  LASG  BA`1C 7 
HTN   X 12 
DLD   X12 
GOUT 


NO  PREVIOUS  SURGERY 


Routin  labs    were done  every  3  months 

medications 
lantus  20 
forxiga  10 mg once 
janeut  50/1000 mg   1x1 
lipitor  40 mg ocne 
alloril  100 mg one 
concor  5 mg ocne 
co  diovan  160/25 
mepral 
multivitamin 


presented   with    heavy albuminuria   moe than  2  gram  2434  mg 

plan 
add   diovan 
consider adding  filrinine 
consider adding  ozepic  later one 
rtc after  2 weeks 