A 71-Year-Old Man Comes to the Physician Accompanied by His

A 71-year-old man comes to the physician accompanied by his wife because of a 6-month history of worsening episodic upper abdominal pain and an 8-kg (17.6-lb) weight loss. The pain is dull, nonradiating, worse after eating, and occasionally associated with bloating and diarrhea. His symptoms have not improved despite 4 weeks of treatment with omeprazole. He attributes his weight loss to recently eating very small portions and avoiding fatty foods. He has hypertension and hypercholesterolemia. Current medications include lisinopril, metoprolol, atorvastatin, and aspirin. He has smoked a pack of cigarettes daily for 40 years. Blood pressure is 175/105 mm Hg and pulse is 70/min and regular.  The abdomen is soft and nontender.  CT scan of the abdomen reveals the renal findings shown in the image below. This patient most likely suffers from which of the following conditions?

A) Acute glomerulonephritis
B) Acute pyelonephritis
C) Amyloidosis
D) Fanconi syndrome
E) Hemolytic uremic syndrome
F) Hypersensitivity interstitial nephritis
G) Ischemic tubular necrosis
H) Myeloma kidney
I) NSAID-associated nephropathy
J) Papillary necrosis
K) Renal artery stenosis
L) Urate nephropathy

Correct Answer:

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