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: epigastric pain with nausea, left arm pain, hypertensive urgency major surgical or invasive procedure: none. history of present illness: mr. is a 43 year-old man with a history of type 1 dm, esrd on hd and frequent admissions for left sided body pain and htn who presents with left sided body pain and hypertensive urgency noted during hd today. he reports 1 week of stomach pain with epigastric burning and vomiting after meals. he states that he has left shoulder pain which has been stable for 4 months. the pain worsens with movement of his left arm. he denies sob, diaphoresis, or dizziness. he states he has had severe left sided flank pain intermittently over the past week. he denies any local trauma. he endorses mild constipation. . he specifically denies any symptoms of vision changes (baseline mild blurry vision), chest pain, difficulty breathing, shortness of , headache, or leg pain. he produces a minimal amount of urine at baseline and denies any dysuria. . in the ed, his initial vital signs were 181/96 99%4l with general abdominal tenderness and left arm pain with movement. he received morphine 4mg, zofran 4mg, asa 325 mg, labetalol 40mg iv in mg doses, and dilaudid 1mg. a labetalol gtt was then started. abdominal ct was unremarkable on preliminary read as was ekg. placed rij central line for access. renal consult evaluated in the ed and recommended hd in am. past medical history: 1. dm1 x 17 years 2. esrd, on hd t,th,sa at 3. htn, poorly controlled 4. r foot operation - bone excision 5. r foot ulcer 6. depression with h/o sa and psych hospitalizations 7. esophagitis on egd with negative h. pylori 8. h/o l flank pain since with multiple admissions and extensive work-up and no organic etiology for pain found 9. diastolic chf: lvef >55% by echo social history: his mother passed away and he now lives alone. he sees his sister and brother on the weekends. has four children. former floor tech. no smoking, etoh, drugs. history of suicide attempt using "lots of pills." family history: diabetes in multiple relatives on both sides. physical exam: vs - afebrile 128/78 59 99% 3l gen - middle aged man, falling asleep during interview heent - ncat, mm dry but cv - rrr, s1, s2, no rmg pulm - crackles up 2/3 left lung, right basilar crackles, no wheezes abd - soft, nd, +bs, tenderness to light palpation over epigastric region otherwise nontender to palpation ext - wwp, 1+ pretibial edema neuro - cn 2-12 fxn , ms throughout, symmetric, a*o*3 pertinent results: admission labs: . 10:15am pt-15.6* ptt-31.0 inr(pt)-1.4* 10:15am plt count-152 10:15am neuts-71.4* lymphs-20.5 monos-5.3 eos-2.2 basos-0.7 10:15am wbc-5.6 rbc-3.92* hgb-10.7* hct-33.9* mcv-87 mch-27.3 mchc-31.6 rdw-19.1* 10:15am calcium-9.4 phosphate-5.4* magnesium-1.9 10:15am ck-mb-11* mb indx-3.8 10:15am ctropnt-0.25* 10:15am lipase-23 10:15am alt(sgpt)-26 ast(sgot)-27 ck(cpk)-286* alk phos-156* tot bili-0.7 10:15am estgfr-using this 10:15am glucose-160* urea n-36* creat-8.1*# sodium-140 potassium-4.6 chloride-102 total co2-24 anion gap-19 pertinent labs/studies: . hct: 33.9 -> 31.5 -> 32.0 (baseline 33-37) gluose: 160 -> 51 -> 135 ck: 286 -> 216 alk phos: 156 troponin: 0.25 -> 0.23 (baseline elevated at 0.16 to 0.43) ekg: sinus @86. lae. no q waves. trace st depressions laterally. cxr: the lungs are clear, without pulmonary airspace consolidation, effusion or evidence of pulmonary edema. cardiac silhouette remains enlarged. hila are within normal limits. osseous structures are unremarkable. ct a/p (): lung bases: there is small right pleural effusion and minimal bibasilar dependent atelectases. the lung bases are otherwise clear. ct of the abdomen with intravenous contrast: ascites and free fluid within the pelvis are not significantly changed. the liver, pancreas, and adrenals are unremarkable. there is small amount of pericholecystic fluid, likely related to ascites. the spleen is mildly enlarged, measuring 13.6 cm. the kidneys are small bilaterally, without focal abnormality identified. the aorta is normal in caliber. prominent nodular soft tissue attenuation adjacent to the ivc may relate to dilated lymphatics and is unchanged. there are no pathologically enlarged mesenteric lymph nodes. the small bowel and colon are normal in caliber, without evidence of wall thickening. ct of the pelvis with intravenous contrast: free fluid within the pelvis is unchanged. the rectum, sigmoid colon, prostate, and seminal vesicles are unremarkable. there is no pelvic or inguinal lymphadenopathy. bone windows: no suspicious lytic or blastic osseous lesion is identified. impression: 1. stable ascites. 2. small right pleural effusion, decreased in comparison to . no evidence of acute intra-abdominal process. 3. splenomegaly. . . discharge labs: 06:10am blood wbc-4.0 rbc-3.57* hgb-9.8* hct-32.0* mcv-90 mch-27.6 mchc-30.7* rdw-17.8* plt ct-121* 06:10am blood plt ct-121* 06:10am blood glucose-135* urean-24* creat-7.0*# na-138 k-4.7 cl-99 hco3-27 angap-17 06:10am blood calcium-8.9 phos-5.2*# mg-1.9 brief hospital course: patient is 44 yo man with history of type 1 diabetes and esrd who presented with flank pain and hypertensive urgency in the setting of prolonged n/v/d. #. hypertensive urgency - patient presented with hypertensive urgency while at . in the ed, his bp was 181/76. he was transferred to the micu, where a central line was placed, and he was started on a labetalol drip. he was weaned off the labetalol during his first night in the micu, after which he was able to tolerate his po medications. it appears that this hypertensive episode was secondary to medication non-compliance amd fluid overload in the setting of n/v/d. the patient was dialyzed twice while in the hospital, and his bp returned to his baseline when po medications were restarted. he was discharged with close outpatient follow-up. . # flank pain: the patient has left-sided flank pain, which has been present since . despite previous workup of ct, mri, and u/s, no clear etiology has been found. it is thought that this may be secondary to thoracic neuropathy. despite multiple pain regimens and pain service consultation, his pain has flared in this manner several times over the last 6 months requiring hospitalization for iv narcotics and bp control. the patient was ruled out for a mi, and he was restarted on his home doses of tylenol, lidocaine patch, duloxetine, and neurontin. he was also given morphine prn for pain. patient tolerated these medications well and stated that his pain was somewhat improved on discharge. #. stage 5 ckd: patient has a history of stage 5 ckd. he received twice during this hospital stay. he was continued on his home regimen of b complex-vitamin c-folic acid 1 mg daily and phoslo 667 tid, as soon as he was able to take oral medications. he did not have any acute events during this hospital stay. . #. diabetes: patient has a history of type 1 diabetes. he was continued on his home regimen of 70/30 home regimen of 15 units in the morning and 20 units with dinner. he tolerated this well and did not have any acute events during this hospital stay. . medications on admission: 1.aspirin 81 mg daily. 2.lisinopril 20 mg daily 3.metoprolol succinate 200 mg daily 4.nifedipine 60 mg sr 5.glycopyrrolate 1 mg tid prn 6.zolpidem 5 mg qhs prn 7.b complex-vitamin c-folic acid 1 mg daily 8.calcium acetate 667 mg tid 9.hydromorphone 2 mg q6h prn 10.gabapentin 250 mg/5 ml 11.valsartan 80 mg 12.sevelamer 800 mg tid 14.insulin (70-30) 15 units in the morning and 20 units at night 15.colace 100 mg daily 16.omeprazole 40 mg daily discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). 3. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 4. nifedipine 60 mg tablet sustained release sig: one (1) tablet sustained release po bid (2 times a day). 5. glycopyrrolate 1 mg tablet sig: two (2) tablet po tid (3 times a day) as needed. 6. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 7. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). 8. gabapentin 300 mg capsule sig: one (1) capsule po q48h (every 48 hours). 9. valsartan 80 mg tablet sig: one (1) tablet po bid (2 times a day). 10. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 13. famotidine 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 14. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 15. insulin nph & regular human 100 unit/ml (70-30) cartridge sig: as directed units subcutaneous twice a day: please use 15 units in the morning and 20 units at night. discharge disposition: home discharge diagnosis: primary: hypertension type 1 diabetes mellitus left flank pain secondary: chronic kidney disease, stage 5 discharge condition: good. patient is able to tolerate his oral medications, and his blood pressure is currently stable. discharge instructions: you were admitted to the hospital because you had nausea and vomiting and your blood pressure was extremely elevated. you were admitted to the micu, where you were started on a labetolol drip. your nausea gradually improved, and you were able to start your oral medications. you were dialyzed twice during this admission, and your blood pressure returned to your baseline. while you were here, we made the following changes to your current medications: 1. we started you on famotidine for your acid reflux. please take all medications as prescribed. please keep all previously please return to the ed or your healthcare provider immediately if you experience shortness of , confusion, chest pain, problems with your vision, headaches, fevers, chills, or any other concerning symptoms. please weigh yourself every morning, and call your doctor if you gain more than 3 lbs. please adhere to a low sodium (2 gm/day)diet. followup instructions: provider: , center (nhb) phone: date/time: 12:15 provider: , av care av care phone: date/time: 10:30 procedure: hemodialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease chronic kidney disease, stage v congestive heart failure, unspecified polyneuropathy in diabetes diastolic heart failure, unspecified abdominal pain, epigastric diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to