A 31-Year-Old Woman, Gravida 2 Para 1, at 30 Weeks

A 31-year-old woman, gravida 2 para 1, at 30 weeks gestation comes to the emergency department due to increased swelling in her face and lower extremities.  She has noticed a sudden onset of swelling and a 2.72-kg (6-lb) weight gain in the last day.  The patient has not urinated in the last 12 hours despite an increase in fluid intake.  She has a twin pregnancy and no chronic medical conditions.  Blood pressure is 154/98 mm Hg, and pulse is 98/min.  Bladder catheterization yields a total of 10 mL of dark urine.  Urinalysis shows no red blood cells.  Which of the following pathologic factors is the most likely cause of this patient's decreased urine output?

A) Inflammation of the glomeruli
B) Immune complex deposition within glomeruli
C) Inflammation of the renal interstitium
D) Obstructing stone within the renal calyx
E) Vasospasm of the intrarenal arteries

Correct Answer:

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