Case 10: Introduction

History of Present Illness (HPI)

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A 36 year old woman with a history of end stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS) on peritoneal dialysis (PD) for 2 years presents to your hospital with 1 day of worsening abdominal pain.

She noted mild, diffuse abdominal discomfort earlier this morning that has gradually worsened. She reports nausea but denies fever, chills, vomiting, or bloody stool. She still makes urine and has not noticed any changes.

The patient is compliant with her peritoneal dialysis and reports using sterile technique. She denies history of any PD complications. She takes sevelamer (phosphate binder) with meals and occasional acetaminophen for headaches. She denies tobacco, alcohol, or illicit drug use. She is sexually active with her boyfriend and reports using condoms. Her only surgical history is PD catheter placement 2 years ago.

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