A 35-year-old man is brought to the emergency department 18 hours after being trapped under a collapsed scaffold at a construction site. He reports severe pain in both legs and dark-colored urine since the accident. On examination, he has significant swelling and bruising of bilateral lower extremities with evidence of muscle necrosis. Vital signs: BP 128/76 mmHg, HR 102 bpm, RR 18/min, temperature 37.2°C. Laboratory studies show: serum creatinine 4.2 mg/dL (baseline 0.9 mg/dL), potassium 6.8 mEq/L, phosphate 7.2 mg/dL, uric acid 11.2 mg/dL, CK 52,000 U/L, and urinalysis with positive myoglobin and muddy brown casts. Which of the following interventions is most critical to prevent further deterioration of renal function?

1. A)Immediate hemodialysis given the elevated potassium and creatinine levels
2. B)High-dose furosemide (250 mg IV) to increase urine output to >200 mL/hr
3. C)Aggressive intravenous normal saline hydration with concurrent sodium bicarbonate to alkalinize urineGABARITO
4. D)Sodium polystyrene sulfonate (Kayexalate) to address hyperkalemia and prevent cardiac arrhythmias
5. E)Mannitol osmotic diuresis without alkalinization to flush myoglobin from the collecting ducts