Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: increased lower extremity edema major surgical or invasive procedure: tunneled catheter placement hemodialysis x 3 sessions history of present illness: this is a 44 yo f h/o dmi, ckd, htn who presented to the ed with anasarca, worsening le swelling, malaise,fatigue and ruq abdominal pain. in the ed she was found to be hypertensive with sbps in the 200's. a nitro gtt was initiated and bp was reduced quickly to 140, which resulted in patient experiencing lightheadedness. patient also found to have a cr of 9.3, her last omr value was 3 in . patient received iv lasix in the ed and was seen by renal who felt she would likely require initiation of dialysis. patient was admitted to the micu for management of her hypertension. in the micu, patient was weaned off her nitro gtt and restarted on her outpatient regimen of labetolol and amlodipine. she was also continued on iv lasix for diuresis goal of one to two liters given her volume overload. she was followed by the renal team who suggested tunnelled line for hd on mon and lab testing/vein mapping in anticipation of fistula placement. at time of transfer to floor, patient had no complaints. past medical history: 1. type i dm - with retinopathy, nephropathy (stage iii). is followed at the by dr / and dr (nephrology) 2. htn 3. depression and anxiety 4. hyperlipidemia 5. s/p d&c, tubal ligation,c-section 6. anemia (on iv iron) 7. hyperparathyroidism social history: never smoked, no etoh, no iv drugs. lives with children. not working. family history: mother: dm; hypertension; dm nephropathy 2 sisters with physical exam: vital signs: t 97.5 bp 118/60 hr 82 rr 15 o2 100 ra general: pleasant, well appearing in nad heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm. op clear. neck supple, no lad, no elevation in jvp cardiac: regular rhythm, normal rate. normal s1, s2. ii/vi systolic ejection murmur heard best at right upper sternal border lungs: ctab, good air movement bilaterally. abdomen: midline abdominal scar. nabs. soft, non-tender, non-distended. back: no flank pain extremities: 2+ pitting edema to knees, 2+ distal pulses neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout. + reflexes skin: venous stasis changes on l shin with both areas of hyperpigmentation and hypopigmentation pertinent results: admission labs: cbc: 12:30pm blood wbc-9.5 rbc-3.31*# hgb-9.8*# hct-29.3*# mcv-89 mch-29.5 mchc-33.3 rdw-15.9* plt ct-379 12:30pm blood neuts-76.7* lymphs-15.3* monos-6.4 eos-1.3 baso-0.3 chemistries: 12:30pm blood glucose-120* urean-95* creat-9.3*# na-136 k-4.6 cl-103 hco3-17* angap-21* 12:30pm blood calcium-7.7* phos-5.9*# mg-2.1 iron-80 cardiac enzymes: 12:30pm blood ctropnt-0.15* 04:30am blood ck-mb-11* mb indx-1.4 ctropnt-0.12* other: 05:00am blood %hba1c-5.8 04:30am blood triglyc-300* hdl-38 chol/hd-4.3 ldlcalc-67 12:30pm blood pth-451* 12:30pm blood hbsag-negative hbsab-negative hbcab-negative ========================= discharge labs: cbc: 07:10am blood wbc-8.2 rbc-2.34* hgb-6.8* hct-20.1* mcv-86 mch-29.1 mchc-33.9 rdw-15.7* plt ct-292 chemistries: 07:10am blood glucose-88 urean-36* creat-5.7*# na-135 k-3.8 cl-101 hco3-26 angap-12 07:10am blood albumin-2.9* calcium-8.1* phos-4.1 mg-1.5* other: 04:30am blood pep-no specifi igg-926 iga-160 igm-193 ife-no monoclo =========================== ecg : sinus rhythm. poor r wave progression which is non-diagnostic. diffuse t wave changes which are non-specific. compared to the previous tracing of no significant diagnostic change. cxr : no acute cardiopulmonary process. renal u/s : 1. bilateral echogenic kidneys, similar in appearance. 2. no evidence of hydronephrosis. 3. small amount of fluid between liver and right kidney and spleen and left kidney. transthoracic echocardiogram : the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is severe pulmonary artery systolic hypertension. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. brief hospital course: this is a 44 year old female with history of dm1, ckd, htn who now presents with lower extremity edema and was found to have significantly worsened renal function requiring initiation of hd. patient initially admitted to the medical icu given hypertension on admission and was then transferred to floor medical service. #. end stage renal disease: on admission cr noted to be 9.8 up from 3 (). thi was felt to be advanced chronic kidney disease rather than due to an acute process. patient followed by the renal consult team who recommended tunneled line placement for initiation of dialysis. patient tolerated her first three dialysis sessions without any complications. she underwent ultrasound vein mapping in anticipation of fistula surgery. patient seen by dialysis social worker who helped coordinate outpatient dialysis. patient discharged with prescriptions for nephrocaps and sevelamer carbonate . #. htn: in the emergency department patient found to be hypertensive with sbps to the 200's. she was started on a nitroglycerin gtt and admitted to the micu for management of her hypertension. nitro gtt was titrated off and patient was restarted on her outpatient regimen of amlodipine and labetolol. patient had no further episodes of hypertension during this hospital course. prior to discharge she was started on lisinopril 5 mg daily and amlodipine was reduced to 5mg daily from 10 mg daily. she also remains on labetolol 300 mg daily. # volume overload: prior to admission patient noticed increasing lower extremity edema. on admission she did not have any evidence of pulmonary edema or elevated jugular venous pressure. lower extremity edema improved slightly with intravenous lasix and patient felt more comfortable ambulating prior to discharge. notably, a transthoracic echocardiogram showed mild lvh, severe pulm htn and 2+ mitral regurgitation. # pulmonary hypertension: echo demonstrated severe pulmonary hypertension. there were no studies for comparison. the etiology of ph is unclear. the patient does not have significant left heart disease would suggest further work-up such as pfts and polysomnography. also want to recheck echo within the next fews weeks to assess whether improved hemodynamics in setting of hd initiation has an effect. #. diabetes, type 1: blood sugars remain well controlled. patient scheduled to follow up with dr. at . #. hyperlipidemia: patient continued on simvastatin. #. anemia: hematocrit slowly trended down over hospital course. this was felt to be secondary to chronic kidney disease. patient transfused 2 units of packed red blood cells prior to discharge. she was also started on epogen and intravenous iron with hd. patient was a full code during this admission. medications on admission: labetalol 300 calcitriol 0.25 mg daily iron asa 81 daily insulin lasix 40 mg amlodipine 10 mg daily zocor 20 mg daily discharge medications: 1. labetalol 100 mg tablet sig: three (3) tablet po bid (2 times a day). 2. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 3. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 * refills:*2* 4. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 5. insulin glargine 100 unit/ml solution sig: 6 units subcutaneous at bedtime. disp:*qs ml* refills:*2* 6. aspirin 81 mg tablet sig: one (1) tablet po once a day. 7. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 8. sevelamer carbonate 800 mg tablet sig: 0.5 tablet po three times a day. disp:*45 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: end stage renal disease, hypertension secondary: type i diabetes mellitus discharge condition: stable discharge instructions: you came to the hospital because you noticed increased swelling in your legs. we determined that you had significantly worsened kidney disease which was likely contributing to the fluid in your legs. you were followed by the kidney doctors who recommended begin dialysis. you had a dialysis catheter placed and have begun dialysis. you tolerated your first three sessions well. . new medications: nephrocaps: this is a vitamin b supplement that you need to take daily lisinopril: this is a medication for controlling blood pressure sevelamer carbonate 400 mg by mouth three times a day with meals.this medication binds extra phosphorous. . medication changes: lantus reduced from 8 units at bedtime to 6 units at bedtime amlodipine reduced from 10 mg daily to 5mg daily . if you experience lightheadedness, chest pain, shortness of breath or any other concerning symptom please contact your primary care physician or come to the emergency department for evaluation. followup instructions: the dialysis social worker will contact you tomorrow regarding when and where you will be starting dialysis. her phone number is (. primary care provider: . 2:00pm, building . diabetologist: you have an appointment with dr. on at 9:00am at the diabetes center. procedure: hemodialysis venous catheterization for renal dialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease anemia in chronic kidney disease end stage renal disease mitral valve disorders congestive heart failure, unspecified acute kidney failure, unspecified other chronic pulmonary heart diseases dysthymic disorder other and unspecified hyperlipidemia secondary hyperparathyroidism (of renal origin) acute diastolic heart failure diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled background diabetic retinopathy venous (peripheral) insufficiency, unspecified 

Answer: The patient is high likely exposed to