A 55-Year-Old Woman with Acute Onset Renal Failure Is Evaluated

A 55-year-old woman with acute onset renal failure is evaluated on the ward. She presented with acute abdominal pain. Her abdominal pain was not proportionate to her physical examination findings. Therefore, she was sent for angiography which confirmed the diagnosis of acute mesenteric ischemia. Today, she was reported to have elevated blood urea nitrogen and serum creatinine levels. The patient does not complain of fever, dyspnea, or palpitations. She has stable vital signs. Physical examination shows no new findings. Which of the following pathologic findings is most likely present in this patient?

A) Diffuse necrosis of the proximal tubular cells
B) Extensive crescents in the glomeruli
C) Fibrin-like material lining the arteriolar walls
D) Mononuclear cell infiltrate in the interstitium
E) needle-shaped clefts in the arterioles

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