A 53-year-old woman with hypertension and chronic active hepatitis B infection.
A 53-year-old woman was evaluated during a routine follow-up visit. Medical history was significant for hypertension and chronic active hepatitis B infection. Her hepatitis B infection was treated with tenofovir for the past 5 years with suppression of her serum hepatitis B DNA levels.
She currently complained of mild generalized weakness but otherwise she felt well. Medications were ramipril and tenofovir. On physical examination, temperature was 37.0 °C (98.6 °F), blood pressure 136/79 mm Hg, pulse rate 70/min, and respiration rate 14/min. BMI was 22. Abdominal examination showed a normal-sized liver and no splenomegaly. The remainder of the examination was normal.
• Bicarbonate 21 mEq/L (21 mmol/L)
• Creatinine 1.2 mg/dL (106.1 µmol/L) (3 years ago: 0.8 mg/dL [70.7 µmol/L])
• Glucose 87 mg/dL (4.8 mmol/L)
• Phosphorus 2.2 mg/dL (0.71 mmol/L)
• Urinalysis 1+ protein 2+ glucose; no cells or casts
Which of the following is the most likely cause of this patient’s kidney findings?
A. Hypertensive nephropathy
B. Membranoproliferative glomerulonephritis
C. Membranous glomerulopathy
D. Tubulointerstitial disease
Answer to be disclosed shortly!
*The present case appears in KevinMD