Spot urine examination revealed protein discharge having  ++++ and 24 hours urine  showed  leakage of 2.4 gram of protein per litre done four days back,ACER ratio 1507, Microalbumin - 369.3,creatinine 23.9 BP fluctuating 138/71 to 190 / 101 Today's result creatinine  1.6 and urea 49 Current medication for Sugar metformin  500 mg high blood pressure 1) Telma 40 mg once  and 2)minipress 2.5 mg (Bd) 3)For Piles -Daflon and 4)For Knee pain Paracetamol and glucosamine