A 23-year-old male presented to the emergency department complaining of unremitting dyspepsia for the last four months. His blood pressure was incidentally found to be 230/157 mm Hg. The initial admitting diagnosis in the intensive care unit was hypertensive "emergency" as he had also displayed acute kidney injury that was deemed to be superimposed on chronic kidney disease. Physical examination was done of the bilateral hands. X rays of the bilateral feet and hands were taken. His family medical history was unknown as the patient was adopted and did not have contact with his biological parents.
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