A 41-year-old man with a 6-month history of poorly controlled hypertension presents to the emergency department with severe frontal headache, dyspnea, and blurred vision that began acutely 4 hours ago. His wife reports he has not been taking his antihypertensive medications. Physical examination reveals bilateral retinal hemorrhages and papilledema. Vital signs: BP 218/138 mmHg, HR 106/min, RR 24/min, SpO2 93% on room air. Laboratory studies show serum creatinine 3.1 mg/dL (baseline 1.0 mg/dL obtained 2 months prior), BUN 68 mg/dL, platelets 84,000/μL (baseline 280,000/μL), and hemoglobin 9.2 g/dL (baseline 14.5 g/dL). Peripheral blood smear demonstrates schistocytes. Urinalysis shows 3+ proteinuria and RBC casts. Chest radiograph is clear without pulmonary edema. Renal artery stenosis is excluded by duplex ultrasound. Which of the following best explains this patient's acute kidney injury?

1. A)Acute tubular necrosis from hypoperfusion
2. B)Acute interstitial nephritis from medication exposure
3. C)Hemolytic uremic syndrome
4. D)Malignant hypertensive nephrosclerosisGABARITO
5. E)Membranoproliferative glomerulonephritis