Case Presentation: A 57 year-old male with history of alcoholic cirrhosis, hypertension, and stage IV chronic kidney disease (CKD) presented to the hospital with bilateral lower extremity edema and shortness of breath. He was diagnosed with worsening CKD meeting criteria for hemodialysis, acute decompensated cirrhosis, severe sepsis due to spontaneous bacterial peritonitis complicated by pansensitive [...]