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: no known allergies / adverse drug reactions attending: chief complaint: left renal mass in a horseshoe kidney major surgical or invasive procedure: 1. open partial nephrectomy (of left renal mass) of a horseshoe kidney. 2. umbilical hernia repair. 3. retroperitoneal lymph node sampling. history of present illness: 43ym who underwent an annual physical exam over the summer with slightly increased lfts leading to an abdominal ultrasound. the ultrasound revealed a horseshoe kidney and a 6 cm renal mass, which was situated in the isthmus of the kidney, slightly to the left. past medical history: diabetes type 2 x1 year, hepatic steatosis, and small umbilical hernia. social history: he works as a leasing consultant for an apartment complex in . no tobacco, occasional alcohol, no drug use. he walks his greyhound 5-20 minutes per day without shortness of breath. family history: positive for kidney tumor in his father, which was apparently benign. physical exam: exam on discharge date: wdwn male, nad, avss interactive, cooperative abdomen soft, appropriately tender along incisions incisions c/d/i w/out evidence hematoma, infection six surgical skin clips remain in place but all other abdominal incision clips have been removed. incision site reinforced with steri-strips. extremities w/out edema or pitting and no report of calf pain pertinent results: 06:00am blood wbc-12.1* rbc-3.26* hgb-9.7* hct-29.7* mcv-91 mch-29.8 mchc-32.7 rdw-14.7 plt ct-270 06:12am blood wbc-15.1* rbc-3.52* hgb-10.4* hct-31.9* mcv-91 mch-29.4 mchc-32.4 rdw-14.8 plt ct-277 01:37am blood pt-13.7* ptt-27.0 inr(pt)-1.2* 07:55am blood glucose-136* urean-12 creat-1.1 na-139 k-4.2 cl-104 hco3-28 angap-11 06:00am blood glucose-106* urean-18 creat-1.0 na-134 k-3.7 cl-101 hco3-25 angap-12 04:01pm blood glucose-218* urean-16 creat-1.3* na-137 k-5.4* cl-107 hco3-23 angap-12 05:47am blood alt-40 ast-23 alkphos-173* amylase-261* totbili-0.9 07:55am blood amylase-224* 05:47am blood albumin-2.9* cholest-167 07:55am blood calcium-8.0* mg-2.0 06:00am blood calcium-7.7* phos-2.8 mg-2.1 brief hospital course: icu course: . # hypotension/tachycardia in the setting of blood loss (3l) during surgery. patient has received significant fluid resuscitation and had required pressor support in the pacu (phenylephrine for a few hours). he was bolused in the as needed o maintain bp. his hct was stable. . # left partial nephrectomy as per urology. will continue with post op pain management with bupivicaine epidural and dilaudid pca. was kept on maintenance ivf's. . # diabetes pt reported on metformin as per records. will hold oral meds and places on riss while on sliding scale. . # gerd - c/w prilosec _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ________________________________________________________________ mr. was admitted to urology after undergoing open left partial nephrectomy. although there were no adverse intraoperative events; the dissection was described as tough, the mass was large and there was high blood loss and fluid resuscitation due to size of resection bed. please see dictated operative note for details. the patient received perioperative antibiotic prophylaxis. the patient was transferred to the unit floor from the pacu in stable condition. on pod1 he was transferred to the general surgical floor where he remained with good pain control coverage with his epidural. he was hydrated for urine output >30cc/hour, and provided with pneumoboots and incentive spirometry for prophylaxis. his post operative course was complicated by post-operative ileus. over the course of several days he was gradually weaned from oxygen support, transitioned to pca from epidural and then to oral pain medications once he reported flatus. it was on , pod3, that his epidural was discontinued and while his pca was maintained. he was weened from ox support and kept on telemetry. awaiting bowel functions as no flatus on morning rounds. he was ambulating regularly. no n/v. his foley was also d/c'd on pod3. he was monitored daily with cbc and basic metabolic panel. with the passage of flatus his diet was advanced to a clears/toast and crackers diet cautiously. his jp output was fairly high as well and this was checked for creatinine levels x two and was normal. the remainder of the hospital course was relatively unremarkable. the patient was discharged in stable condition, eating well, ambulating independently, voiding without difficulty, and with pain control on oral analgesics. on exam, incision was clean, dry, and intact, with no evidence of hematoma collection or infection. the patient was given explicit instructions to follow-up in clinic in one week with dr. for staple removal (six remaining). he was given instructions to follow-up with his primary care doctor as well. medications on admission: nkda meds: metformin 500' and omeprazole 20'. discharge medications: 1. colace 100 mg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 3. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain >. disp:*50 tablet(s)* refills:*0* 4. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day): hold for sys<100, hr<60 . disp:*120 tablet(s)* refills:*2* 5. simethicone 80 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day) as needed for gas pain. 6. acetaminophen 500 mg tablet sig: two (2) tablet po q8h (every 8 hours). 7. metformin 500 mg tablet sig: one (1) tablet po daily (daily). 8. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 9. outpatient lab work please monitor your blood pressure regularly and keep a log of your values to present to your pcp. up with your pcp, . , within the next 1-2 weeks time to reveiw your post operative course and medications. discharge disposition: home discharge diagnosis: preoperative diagnosis: tumor, suspicious for renal cell carcinoma. postoperative diagnosis: tumor, suspicious for renal cell carcinoma. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: -please also refer to the provided written instructions on post-operative care, instructions and expectations made available from dr. ??????s office. -resume your pre-admission/home medications except as noted. always call to inform, review and discuss any medication changes and your post-operative course with your primary care doctor. -you have been started on new medication to help control your blood pressure/heart rate. you should follow up with your pcp, . , within the next 1-2 weeks time to reveiw your post operative course and medications. -do not lift anything heavier than a phone book (10 pounds) or drive until you are seen by your urologist in follow-up -resume all of your pre-admission/home medications except as noted. -call your urologist's office today to schedule/confirm your follow-up appointment in 2 weeks and if you have any questions. -do not eat constipating foods for 2-4 weeks, drink plenty of fluids to keep hydrated -no vigorous physical activity or sports for 4 weeks or until otherwise advised -tylenol should be your first line pain medication, a narcotic pain medication has been prescribed for breakthrough pain >4. replace tylenol with narcotic pain medication. -max daily tylenol (acetaminophen) dose is 4 grams from all sources, note that narcotic pain medication also contains tylenol -if you have been prescribed ibuprofen (the ingredient of advil, motrin, etc.) , you may take this and tylenol together (alternating) for additional pain control---please try tylenol first and take the narcotic pain medication as prescribed if additional pain relief is needed. -ibuprofen should always be taken with food. please discontinue taking and notify your doctor should you develop blood in your stool (dark tarry stools) -you may shower normally but do not immerse your incisions or bathe -do not drive or drink alcohol while taking narcotics and do not operate dangerous machinery -colace has been prescribed to avoid post surgical constipation and constipation related to narcotic pain medication. discontinue if loose stool or diarrhea develops. colace is a stool-softener, not a laxative -if you have fevers > 101.5 f, vomiting, or increased redness, swelling, or discharge from your incision, call your doctor or go to the nearest emergency room. followup instructions: -not all of your surgical skin clips were removed... six remain. please call to re-schedule your dr. f/u appointment and to have these 'staples' removed. -call dr. office at ( for follow-up and if you have any urological questions. dr. ??????s nurse practitioner may be reached at the same number. you must follow up with your pcp, . , within the next weeks time to reveiw your post operative course and medications. pcp: , procedure: other open umbilical herniorrhaphy partial nephrectomy insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt simple excision of other lymphatic structure diagnoses: other iatrogenic hypotension esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled malignant neoplasm of kidney, except pelvis hemorrhage complicating a procedure paralytic ileus umbilical hernia without mention of obstruction or gangrene other chronic nonalcoholic liver disease other specified anomalies of kidney 

Answer: The patient is high likely exposed to