Case Presentation: A 59-year-old male presented to the ED with tachycardia, hypotension, and three days of vomiting and abdominal pain. He was recently hospitalized for acute hypoxic respiratory failure after several missed hemodialysis sessions. His comorbidities include end-stage renal disease (ESRD) on hemodialysis, peripheral neuropathy on tramadol, and peritoneal mesothelioma not on treatment. Initial labs [...]