85   years old male pt 
known to   have  
htn 
dld 
pacemaker   at jordan 
  he had abdominal us  showed  right  kidney  9.,5 m cm   with corticla thickness   1-1.3 
the left kidney  showed increased parenchymal  echogenecity   as  well as  multiple  pyramidal cyst     5    5.5 
noermla  cortical thickness 
no stone n
no hydronephrosis 
left kdiney  10.3    cortical thickness   1.5-1.8 
BPH     size   178 
normal liver 
6

medication 
xatral   10 mg ocne 
nifidipn  30 mg ocne daily 
valsadipin   160/5/12.5 
ciprocare   500 mg once 
uroclaen  
b12 

creatiine   4.46 
bun  46 
hgb  13 


impression 
bph 
ckd 


plan 
stop vasadipin 
add   cadex  4 mg  1x2 
add alfacal 
add  calcium 
rtc after one  month 
