Young Man with Acute Renal Failure: What is the most likely diagnosis?

Author: Joshua Schwimmer, M.D., FACP, FASN
Reviewer: V. Dimov, M.D.

An otherwise healthy 30 year-old man presents with nausea and fatigue for 2 weeks.

He is found to have BUN of 172 mg/dL, creatinine of 13 mg/dL, and albumin of 4 mg/dL. His urinalysis reveals 3+ protein (quantified at 400 mg per day) and many RBCs.

There is no lower extremity edema. He is nonoliguric.

What is the most likely diagnosis?
1. HIV-associated nephropathy
2. ANCA-associated glomerulonephritis
3. Focal segmental glomerulosclerosis
4. Urinary tract obstruction
5. Minimal change disease

Answer: (highlight the line below with the mouse to see the answer)
2. ANCA-associated glomerulonephritis


Published: 11/01/2006
Updated: 09/08/2009

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9 Comments:

Anonymous Anonymous said...

5

2/02/2009 1:36 AM  
Anonymous Anonymous said...

Dear Anon,

Answer: 5. Minimal change disease is incorrect. There should not be "many RBCs" on UA in minimal change disease.

2/02/2009 9:18 AM  
Anonymous Anonymous said...

Ig A nephropathy is in DDx

2/15/2009 11:59 PM  
Anonymous tb said...

this ia a picture of agn as the sediment is nephritic. theanswer is anca + gn

9/08/2009 4:44 AM  
Anonymous Anonymous said...

please send me the answer

11/29/2009 10:25 AM  
Anonymous Anonymous said...

I would say the answer is 2. Most probable nephritic sx and rapidly progressive

2/03/2010 1:35 PM  
Anonymous Anonymous said...

Minimal chain disease presenting with ARF.

5/04/2010 1:13 PM  
Anonymous Anonymous said...

ANCA-associated glomerulonephritis

7/13/2010 7:25 AM  
Anonymous Anonymous said...

Focal segmental glomerulonephritis

7/14/2010 5:36 AM  

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