A 44-Year-Old Man Comes to the Emergency Department Because of a Severe

A 44-year-old man comes to the emergency department because of a severe headache and blurry vision for the past 3 hours. He has hypertension treated with hydrochlorothiazide. He has missed taking his medication for the past week as he was traveling. He is only oriented to time and person. His temperature is 37.1°C (98.8°F) , pulse is 92/min and regular, and blood pressure is 245/115 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