A 65-Year-Old Man Comes to the Office for Evaluation of Blood

A 65-year-old man comes to the office for evaluation of blood in the urine.  The patient has no abdominal pain, urinary frequency, or urgency.  He has hypertension, type 2 diabetes mellitus, and stage II chronic kidney disease.  He quit smoking 10 years ago and had smoked a pack of cigarettes daily for 30 years.  On examination, vital signs are within normal limits.  The patient's BMI is 33 kg/m².  After appropriate work-up, the patient undergoes a renal biopsy; histopathologic findings are shown below. Which of the following processes most likely accounts for the abnormal appearance of these cells?

A) Glycogen and lipid accumulation
B) Karyorrhexis
C) Membrane lipid peroxidation
D) Mitochondrial swelling
E) Pigment accumulation

Correct Answer:

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