A 46-year-old patient visits her physician with a complaint of chest pain,blood in her urine,and oliguria.She states that these symptoms have gotten worse over the past 2 to 3 months.Urine and blood samples are collected.Urine GFR is calculated to be 40 mL/min/1.73 m² and hemoglobin is 8 g/dL.Urine protein was elevated,with the presence of red blood cell casts.Upon review of her health history,it was noted that she was a cigarette smoker with hypertension.The most likely diagnosis in this case would be:

Question

Quizplus · Accepted Answer

The patient's symptoms, including chest pain, blood in urine, and oliguria, along with elevated urine protein and red blood cell casts, suggest renal dysfunction. The calculated urine GFR of 40 mL/min/1.73m2 and hemoglobin level of 8 g/dL further support this diagnosis. Additionally, the patient's history of smoking and hypertension are risk factors for chronic kidney disease (CKD). Nephrotic syndrome typically presents with significant proteinuria and edema, while end-stage renal disease (ESRD) refers to advanced CKD with irreversible kidney damage. Chronic pyelonephritis may present with urinary tract infections and fever but is less likely given the patient's symptoms and history.

A 46-Year-Old Patient Visits Her Physician with a Complaint of Chest