What is the most likely cause of renal failure in the patient described below?
A 65-year-old woman has experienced increasing malaise with nocturia and polyuria for the past year. On physical
examination, her blood pressure is 170/95 mm Hg. Urinalysis shows a pH of 7.5; specific gravity 1.010; 1+ proteinuria; and no glucose, blood, or ketones. The tests for leukocyte esterase and nitrite yield positive results, and levels of serum urea nitrogen and serum creatinine are elevated. Her clinical course is characterized by worsening renal failure, and she dies of bronchopneumonia. At autopsy, the kidneys are shrunken but unequal in size and have deep, irregular surface scars. On sectioning, the calyces underlying the cortical scars are blunted and deformed.
Change Image Delete
A. Chronic glomerulonephritis B. Essential hypertension C. Reflux nephropathy D. Autosomal-dominant polycystic kidney disease E. Systemic lupus erythematosus
Reflux nephropathy-(c) this description of the gross appearance of the kidney is characteristic of chronic pyelonephritis, caused mostoften by reflux nephropathy. typical features include coarse and irregular scarring resulting from ascending infection,blunting and deformity of calyces, and asymmetric involvement of the kidneys. the loss of tubules from scarring gives riseto reduced renal concentrating ability; the patient had polyuria with a low specific gravity of the urine. chronicglomerulonephritis, benign nephrosclerosis (caused by essential hypertension), and systemic lupus erythematosusproduce bilateral symmetric involvement, and the affected kidneys are shrunken and finely granular. autosomal-dominantpolycystic kidney disease is characterized by large cysts that replace the renal parenchyma and greatly increase the sizeof the kidneys bilaterally.bp7 529530bp8 562563pbd7 10001001pbd8 942944