### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello doctor my father is type 2 diabetic is under insulin his blood sugar is under control . he had his all the investigations from delhi gangaram hospital around 1 years back he had this diabetic nephropathy but his creatinine at that time was 1.9 recently i asked for hid blood checked and his recent reports shows GLucose F 97mg/dl pp 156mg/dl UREA: 169 mg/dl Creatinine 6.62mg/dl Na:132 potassium: 4.5 uric acid 4.0mg/dl cholesterol 100mg/dl calcium 7.8mg/dl phosphorus inorganic 5.9mg/dl tsh 28.88uIU/ml hemoglobin 8.2gm% Total count 8400/cmm Urine R/E Ph acidic Albumin +++ sugar trace M/E RBC 0-2 pus cells 1-3 epithelial cells 0-2 IRON PROFILE Iron 91microgm/dl TIBC 311 microgm/dl Ferritin 362 nanogm/ml IMMUNOLOGY PTH 100.5pg/ml We have planned for the ultrasound and 24hr protein and Creatinine Clearance He is completely asymptomatic no nausea vomiting his urine input output charting is normal we are still under investigation wat do you think do we need to investigate more ? Do prostate also have any role in the above mentioned values? please tell me the best possible investigations that could be done i am from nepal but recently i am in japan so please tell me the best possible management for him as i would like to do every possible thing available . thank you

### output:

Hello and welcome to Chat Doctor. Kasthu CIA. Ramro ?.. As a Urologist, let me advise you, that your fathers Diabetic Nephropathy has increased from 1.9 creatinine, to 6.62. He has anemia, Hb of 8.2gm/ml, with luminaria (urine-alb:3+). Now, his HbA1C, is not done.  But other reports are as expected. But treatment taken at present isn't mentioned to give you proper advice. You can reply to me with the reports of US scan, and 24 hours protein and Cr.clearance. It should show proteinuria as expected. Dietary advice is important. You may contact me with all reports, as a direct question. Chat Doctor. Manga.