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65646 Surgery

A 29-year-old male with HIV, on indinavir, zidovudine, and stavudine, presents with severe edema and a serum creatinine of 2.0 mg/dL. He has had bone pain for 5 years and takes large amounts of acetaminophen with codeine, aspirin, and ibuprofen. He is on prophylactic trimethoprim sulfamethoxazole. Blood pressure is 170/110; urinalysis shows 4+ protein, 5 to 10 RBC; 24-h urine protein is 6.2 g. What is the most likely cause of his renal disease?

AIndinavir toxicity
BAnalgesic nephropathy
CTrimethoprim sulfamethoxazole-induced interstitial nephritis
DFocal sclerosis
Surgery
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