A kidney transplant recipient presents with a creatinine that has doubled over 5 days with no fever, oliguria, or graft tenderness, and a therapeutic tacrolimus level. What is the MOST appropriate next diagnostic step?
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A
Empiric pulse-dose steroids for presumed rejection
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B
Renal transplant biopsy to differentiate rejection from other causes
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C
Increase tacrolimus dose to higher target
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D
Initiate dialysis immediately