A 60-year-old male with a history of chronic kidney disease (CKD) diagnosed 3 years ago, on thrice-weekly hemodialysis, presented to the emergency department with a one-month history of hemoptysis and hematuria over the past two weeks. On physical examination, the patient exhibited hypotension (blood pressure 90/60 mmHg), tachycardia (heart rate 115 bpm), low levels of oxygen saturation on room air (SpO2 83%) which improved with supplemental oxygen at 2 L/min, and bibasal hypoventilation without added respiratory sounds.
