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: history of the present illness: this is a 56-year-old male with a past medical history significant for insulin-dependent diabetes mellitus, hypertension, hypercholesterolemia, renal insufficiency, and coronary artery disease with recent non st elevation mi on . allergies: the patient has no known drug allergies. admission medications: 1. paxil 20 mg p.o. q.d. 2. lipitor 20 mg p.o. q.d. 3. insulin regular 8 units b.i.d. and nph 30 units in the morning, 20 units in the evening. 4. metformin 1,000 mg q.a.m. and 800 mg q.p.m. 5. diltiazem 360 mg q.d. 6. aspirin. 7. lisinopril 40 mg p.o. q.d. 8. hydrochlorothiazide. this is a 56-year-old male who has had several week symptoms including dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, who was admitted to and transferred for cardiac catheterization on to - . cardiac catheterization revealed 80% left main disease and 100% right coronary artery disease. the patient's creatinine level prior to admission was 3.8 and ranged to 4.2 precatheterization with his chronic renal insufficiency due to his diabetes and hypertension. hospital course: the patient was subsequently referred to cardiac surgery for coronary artery bypass grafting. the patient underwent coronary artery bypass grafting on . total cross-clamp time 37 minutes, total cardiopulmonary bypass time 66 minutes. the patient underwent coronary artery bypass grafting times three with the left internal mammary artery to the left anterior descending coronary artery, reversed saphenous vein graft from the aorta to the distal right coronary artery and reversed saphenous vein graft from the aorta to the obtuse marginal coronary artery. the patient was transferred in stable condition to the cardiac surgery recovery unit on propofol and milrinone. on postoperative day number one, 24-hour events included blood transfusion times one for a hematocrit of 27. post-transfusion hematocrit was 28. the patient also had decreased urine output and a blood pressure of 65 for which he was administered 2 mg of neo-synephrine and administered lasix for the decreased urine output. the patient was still on neo-synephrine at 1 and milrinone. on physical examination, the patient was arousable, moving all four extremities. vital signs were stable, in sinus rhythm with a heart rate of 92. white count 10, platelet count 286,000. renal came by to see the patient for the patient's decreased urine output, at which time they recommended to increase the intravascular volume and increase the patient's blood pressure by transfusing units of packed red blood cells and starting epogen 5,000 t.i.w. and 1 liter of d5w with 3 amps of bicarbonate over the day. they did not feel that there was any indication for dialysis that day but it may be an issue in the next few days. they also recommended to continue the neo-synephrine drip with a goal blood pressure of 130-140. they recommended to hold off on diuretics for now as the cvp and pads are low. they recommended to check the urine electrolytes, sodium, creatinine, urea, and to check the urine protein-creatinine ratio. they also felt that the patient's volume status appeared intravascularly depleted with a low cvp and they recommended to give volume and hold the diuretics. they thought that the metabolic acidosis was secondary to acute renal failure and, therefore, to administer the bicarbonate as suggested earlier. dose the patient's vancomycin by levels. on postoperative day number two, 24-hour events included administering 2 units of packed red blood cells as well as administrating bicarbonate. the patient was still with variable urine output and acidosis. on physical examination, the patient was arousable and alert, moving all four extremities. no longer on any drips. the vital signs were stable. the patient was in sinus rhythm at 84 with a blood pressure of 156/61 and a cardiac index of 2.95 with a bun of 80 and creatinine of 5.9 which is up from 4.7, white count 13.8, and hematocrit of 29.1. renal came by and saw the patient again, at which time they stated that the patient had worsening renal function; however, the patient is still putting out urine, is not oliguric, although the picture could worsen. they did not feel that there was the need for hemodialysis at that time. however, they stated that they would continue to monitor for hemodialysis potential. they also felt that since his blood pressure was improved, lasix could be administered 100 mg iv in order to increase diuresis. they also recommended to avoid magnesium and potassium and to give amphojel 30 cc q.o.d. or tums two p.o. t.i.d. with meals for phosphorus binding. they also recommended to give lactulose to promote bowel movements. on postoperative day number three, the patient was hemodynamically stable. the physical examination remained unchanged. the white count came down to 8.9, hematocrit stable at 27, bun 92, creatinine 6.5, with adequate urine output. renal came by to see the patient again, at which time they recommended to transfusing to maintain a hematocrit of greater than 30, continue amphojel at 30 cc p.o. t.i.d. with meals for increasing the phosphorus until the phosphorus level was less than 5, decrease the zantac from 150 mg p.o. b.i.d. to q.d., continue the epogen, and they stated that the patient is close to possibly needing hemodialysis. however, they do not want to remove fluid too quickly whether by diuresis or hemodialysis because this might induce more hypotension and it would decrease the patient's chance for renal recovery. the renal attending came by the same day and stated that once a line is placed he felt that it would be necessary to proceed with hemodialysis and ultrafiltration, at which time they will give some iv epogen. the patient underwent hemodialysis after a quinton catheter was placed on . the patient underwent hemodialysis that day which he tolerated with a blood pressure around 140-150. on postoperative day number four, the patient remained hemodynamically stable, afebrile, with a stable white count and hematocrit, bun 69, creatinine 5.1. renal came by and saw the patient again, at which time they stated that there was no need for dialysis that day; however, he may need it in the morning. they recommended to give tums t.i.d. with meals and snacks for hyperphosphatemia and the patient received epogen yesterday for his mild anemia. on postoperative day number five, the patient continued to remain afebrile, hemodynamically stable with a stable white count and hematocrit. renal came by and stated that as far as the patient's volume status was concerned he was still 10 kilograms above his preoperative weight. they wanted the goal to remove 3 kilograms today during hemodialysis and to check the phosphorus and if it is less than 5, they will be discontinuing the amphojel and during hemodialysis which was planned to be performed that day they will be administering 5,000 of epogen. hemodialysis was performed on , at which time 3 kilograms was removed. the patient remained in sinus rhythm throughout dialysis, however, with occasional to frequent pvcs with a stable blood pressure. the patient was subsequently transferred to the floor on postoperative day number five in stable condition. on postoperative day number six, the patient remained hemodynamically stable with a stable white count and hematocrit, bun 83, creatinine 5.4, with an unremarkable physical examination. renal came by to see the patient, at which time they stated that the patient did still remain oliguric; however, they would continue to observe daily to determine the patient's dialysis need. they recommended to check the patient's calcium and phosphorus and to avoid nsaids, to use lactulose for constipation and to avoid magnesium-containing compounds due to his renal failure. on postoperative day number seven, the patient continued to remain hemodynamically stable, in sinus rhythm at 66. physical examination remained unchanged. the plan was for the patient to undergo hemodialysis that day. the patient did undergo hemodialysis with the plan to undergo hemodialysis for three hours. again, renal saw the patient. at this time, they again stated to avoid magnesium-containing compounds. on postoperative day number eight, the patient continued to remain hemodynamically stable with a bun of 74 and creatinine of 4.9. on postoperative day number nine, regarding 24-hour events, the patient was reportedly feeling well and anxious to leave the hospital. the last hemodialysis was on . the patient still remained hemodynamically stable, putting out sufficient urine. the physical examination remained benign. the bun was 55, creatinine 4.3. the plan was to continue to follow the laboratories to determine whether or not he will need further hemodialysis. renal came by and saw the patient on postoperative day number nine, at which time they stated that the urine output was somewhat better with a good blood pressure. however, the creatinine was still elevated over the last 24 hours. they recommended to repeat a stat potassium and if the potassium was better to hold off on hemodialysis with the potassium being 5.0 with slight hemolysis that day. they also recommended to elevate the legs as much as possible and to continue aluminum hydroxide until the phosphorus is less than 5. on postoperative day number ten, the patient was afebrile. the vital signs were stable with a stable blood pressure of 110-160/70s-80s and the heart rate in sinus rhythm at 60. the physical examination remained unchanged with lungs that were clear and lower extremities with mild edema. the white count and hematocrit were stable with a bun of 58 and creatinine of 4.2 with the plan to discharge the patient that day. the patient was discharged to care group vna on the following medications. discharge medications: 1. lopressor 12.5 mg p.o. b.i.d. 2. aspirin 325 mg p.o. q.d. 3. protonix 40 mg p.o. q.d. 4. insulin nph 30 units q.a.m., 20 units q.p.m. 5. insulin regular 8 units q.a.m., 8 units q.p.m. 6. ferrous gluconate 300 mg p.o. q.d. 7. nephrocaps one p.o. q.d. 8. tums one tablet t.i.d. with meals. 9. epogen 4,000 units subcutaneously two times per week, and thursday. 10. paxil 20 mg p.o. q.d. 11. lipitor 20 mg p.o. q.d. 12. percocet one to two tablets p.o. q. 4-6 hours p.r.n. pain. discharge instructions: the patient to have drawn a cbc, chem-7, calcium, magnesium, phosphorus, and albumin on , , with the results to be sent to dr. at with the patient checking daily weights and daily blood pressures. the laboratory results were to be faxed on , to , attn: and dr. . discharge diagnosis: 1. coronary artery disease, status post coronary artery bypass grafting times three on . 2. chronic renal failure. 3. insulin-dependent diabetes mellitus. 4. hypertension. 5. hyperlipidemia. disposition: the patient is in stable condition. discharge instructions include the patient to make an appointment to visit dr. in four to six weeks. , m.d. dictated by: medquist36 procedure: single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries hemodialysis venous catheterization for renal dialysis diagnoses: acidosis subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery pure hypercholesterolemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease 

Answer: The patient is high likely exposed to