question: Q:A 55-year-old Caucasian woman visits her family physician for a checkup and to discuss her laboratory results from a previous visit. The medical history is significant for obesity, hypothyroidism, and chronic venous insufficiency. The medications include thyroxine and a multivitamin. In her previous visit, she complained about being hungry all the time, urinating multiple times a day, and craving water for most of the day. Blood and urine samples were obtained. Today her blood pressure is 120/70 mm Hg, the pulse is 80/min, the respiratory rate is 18/min, and the body temperature is 36.4°C (97.5°F). The physical examination reveals clear lungs with regular heart sounds and no abdominal tenderness. There is mild pitting edema of the bilateral lower extremities. The laboratory results are as follows:
  Elevated SCr for an eGFR of 60 mL/min/1.73 m²
  Spot urine albumin-to-creatinine ratio 250 mg/g
  Urinalysis
  Specific gravity 1.070
  Proteins  (++)
  Glucose (+++)
  Nitrites  (-)
  Microscopy
  Red blood cells none
  White blood cells none
  Hyaline casts few
  A bedside renal ultrasound revealed enlarged kidneys bilaterally without hydronephrosis. Which of the following kidney-related test should be ordered next?? 
  {'A': 'Renal arteriography', 'B': 'Renal biopsy', 'C': 'Urine protein electrophoresis', 'D': 'Renal computed tomography', 'E': 'No further renal tests are required'},