A 58-Year-Old Man Comes to the Emergency Room Due to Headache

A 58-year-old man comes to the emergency room due to headache.  Medical history is significant for long-standing hypertension and medication nonadherence.  Blood pressure on arrival is 231/135 mm Hg.  Twenty minutes after intravenous hydralazine is administered, blood pressure is 145/95 mm Hg.  Over the following 24 hours, serum creatinine increases from 1.1 to 1.6 mg/dL.  Urine sediment demonstrates abundant granular casts.  Which of the following processes best explains this patient's acute kidney injury?

A) Alteration of the blood pressure-flow relationship in renal arterioles
B) Drug-induced glomerular injury due to immune complex formation
C) Drug-induced renal interstitial inflammation
D) Drug-induced renal tubular injury due to crystal deposition
E) Prerenal azotemia due to a global reduction in cardiac output