53      years old  male pateint 
2026     he started to have   headache 
 he was referred to us  for the proteinuria   and  creatinien   1/4 

creatinine  2.7   then improved   1.4 
hepatitis  vaccination 


creatinine   1/4 
urine protein/creatinine r atio  450 
ldl  74
trigleceride      290 

he ahs been  on  amicor      140/90   concor  2.5 


plan 
stop alfacal 
rtc after one montha fter  doing  esr 
pth 