A 60-Year-Old Woman Is Being Evaluated for Abnormal Renal Function

A 60-year-old woman is being evaluated for abnormal renal function.  She is found to have a serum creatinine of 2.2 mg/dL on routine laboratory monitoring; her creatinine level a year ago was 1.2 mg/dL.  The patient has a history of nonischemic cardiomyopathy and systolic heart failure and has been on a stable medical regimen for the past 2 years.  She has no dyspnea, fever, rash, or lower extremity swelling but has been taking ibuprofen for 2 weeks due to left knee osteoarthritis.  Urinalysis reveals the following: Ibuprofen is discontinued, and her kidney function returns to normal in a week.  Which of the following best explains this patient's transient deterioration in renal function?

A) Impaired afferent arteriolar vasodilation
B) Impaired efferent arteriolar vasodilation
C) Interstitial inflammation
D) Toxic injury to the proximal tubules
E) Vasculitis of the glomerular capillaries

Correct Answer:

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