A 68-year-old patient with end-stage renal disease (ESRD) pr…
A 68-year-old patient with end-stage renal disease (ESRD) presents to the hospital with complaints of progressive shortness of breath, orthopnea, and fatigue over the past 48 hours. The patient has been on hemodialysis for 1 year due to diabetic nephropathy. Physical examination reveals tachypnea, bibasilar crackles on auscultation, jugular venous distention (JVD), and pitting edema in the lower extremities. The patient’s blood pressure is 180/100 mm Hg, heart rate is 110 bpm, and oxygen saturation is 85% on room air. Laboratory results show: BUN: 88 mg/dL Creatinine: 6.5 mg/dL Sodium: 135 mEq/L Potassium: 5.0 mEq/L Which of the following is the most likely cause of the patient’s pulmonary symptoms?