A 50-year-old diabetic man develops AKI after starting an ACE inhibitor. Renal artery duplex shows >70% stenosis bilaterally. What is the mechanism of AKI in this patient?
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A
Direct tubular toxicity from ACE inhibitor
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B
Loss of efferent arteriolar tone causing drop in glomerular perfusion pressure
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C
Immune-mediated interstitial nephritis
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D
Afferent arteriolar vasoconstriction