History

An 80-year-old woman was admitted with a history of cough and gradually worsening shortness of breath of 3 months duration. Respiratory system examination revealed tracheal shift to the left, together with impaired percussion, diminished breath sounds and crackles at the left base. Her medical history included chronic renal failure for which she received haemodialysis three times a week. Her current medications included Sevelamer tablets 800 mg three times a day. The patient was on this particular medication for a period of 10 months prior to admission. There was no history of any …