Intrinsic acute kidney injury (glomerular causes) Quiz: Ace Your Exams
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A 45-year-old nonbinary individual presents to the clinic with progressive swelling in the legs and around the eyes over the past two weeks. There is associated fatigue but no hematuria, recent infections, fever, or weight loss. Medical history includes well-controlled hypertension managed with amlodipine. Temperature is 37°C (98.6°F), blood pressure is 164/92 mmHg, heart rate is 88/min, respiratory rate is 14/min, and oxygen saturation is 98% on room air. There is 3+ pitting edema in both lower extremities. Laboratory results are shown below. A renal biopsy reveals thickening of the glomerular basement membrane without significant hypercellularity and subepithelial deposits forming a "spike and dome" pattern on electron microscopy. Which of the following is the most likely diagnosis?
| Laboratory Test | Result |
| Serum creatinine | 1.4 mg/dL |
| Blood urea nitrogen (BUN) | 22 mg/dL |
| Albumin | 2.2 g/dL |
| Total cholesterol | 280 mg/dL |
| Urinalysis | 4+ protein, no blood |
| 24-hour urine protein | 5.5 g/day |
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