A patient in septic shock becomes oliguric, and the urine contains muddy-brown granular casts. The biopsy shown has flattened tubular epithelium with loss of the brush border and sloughed cells and casts within the lumina. Which process is this, and why does the glomerular filtration rate fall?
A) Acute tubular injury; tubuloglomerular feedback causes afferent vasoconstriction and casts obstruct the tubules
B) Prerenal azotaemia with intact tubules
C) Crescentic glomerulonephritis
D) Membranous nephropathy
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September 5, 2026 521
