A 44-Year-Old Man Comes to the Office for a Routine

A 44-year-old man comes to the office for a routine check-up.  Past medical history is significant for hypercholesterolemia, which he has controlled through diet.  His father died of a myocardial infarction at age 56, and his mother, who is still living, has a history of stroke.  On physical examination, the patient's blood pressure is 160/100 mm Hg and heart rate is 70/min.  He is started on enalapril.  During the first 7 days of therapy, the patient's glomerular filtration rate (GFR) adjusts as shown in the graph below. Which of the following structures was most likely affected by a downstream effect of enalapril and is therefore responsible for this patient's renal response?

A) Afferent arterioles
B) Distal tubules
C) Efferent arterioles
D) Proximal tubules
E) Vasa recta

Correct Answer:

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