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26th June 2023
A 37-year-old man is referred to the renal team following an admission with left flank tenderness and swelling in his legs
A 37-year-old man is referred to the renal team following an admission with left flank tenderness and swelling in his legs, and was noted to have an acute kidney injury on admission bloods. The renal consultant hints to you that he has an autosomal recessive condition for which he was started on a new medication three days ago. Prior to this his renal function was normal. On examination, you notice strange rings in his eyes and his fingernails look blue.
Blood tests and a urine dipstick reveal:
| Na⁺ | 141 mmol/L | (135-145 mmol/L) |
| K⁺ | 5.9 mmol/L | (3.5-5.3 mmol/L) |
| Urea | 25 mmol/L | (2.0-7 mmol/L) |
| Cr | 460 μmol/L | (55-120 μmol/L) |
| Alb | 22 g/L | (34-54 g/L) |
| AST | 52 IU/L | (3-30 IU/L) |
| ALT | 55 IU/L | (3-40 IU/L) |
| ALP | 220 IU/L | (30-100 IU/L) |
| Total Bilirubin | 25 μmol/L | (3-17 μmol/L) |
| Urinary protein | 13.8g/24 hours | |
| Urine Dipstick | Protein +++ | |
| Blood + | ||
What is the most likely nephropathy to cause the deterioration in the renal function?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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