A 55-Year-Old Man Is Being Evaluated for Fatigue

A 55-year-old man is being evaluated for fatigue.  He has a history of hypertension and chronic low back pain due to a traumatic injury 20 years ago.  His medications include lisinopril and over-the-counter pain medications.  His father has diabetes and his mother has hypertension.  He does not use tobacco, alcohol, or illicit drugs.  His blood pressure is 130/80 mm Hg and pulse is 80/min.  Physical examination is unremarkable.  Laboratory studies are as follows: Laboratory studies show serum creatinine level of 2.2 mg/dL and blood urea nitrogen of 34 mg/dL.  Which of the following is the most likely cause of this patient's urinary findings?

A) Glomerulonephritis
B) Nephrolithiasis
C) Tubulointerstitial nephritis
D) Urinary tract infection
E) Urothelial malignancy

Correct Answer:

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