<prompt> A 8 years old child with BP 180100 mm Hg, Blood Urea 90 mgdl, creatinine 5.3 mgdl, urinalysis shows 15-20 pus cells, 1-2 RBC, protein 1; Most likely diagnosis is:Post Infective glomerulonephritisAccelerated hypertension with ARFIdiopathic RPGNChronic interstitial nephritis with VUR  <response>: d. Chronic interstitial nephritis with VURRef: Nelsons 20e p 2537, Ghai 8e p 483In the given clinical scenario, child has hypertension, renal failure increased urea and creatinine, pyuria, absence of hematuria presence of 5RBCsHPF is considered significant and mild proteinuria, Out of the options given, Chronic Interstitial Nephritis with VUR seems most appropriate diagnosis.Chronic Interstitial diseaseIn children, it commonly occurs as a result of underlying obstructive uropathy or VURPresence of urinary tract infection due to VUR explains the presence of pus cell on urinanalysisHypertension is common in chronic interstitial nephritis; Proteinuria is mild 1.5gday.About other options:a. Post-infective glomerulonephritis: Absence of hematuria and presence of mild proteinuria rules out post infective glomerulonephritis. It is always accompanied by significant proteinuria and hematuriab. Accelerated hypertension with acute renal failure: This cannot explain the presence of pus cells on urinalysisc. Idiopathic RPGN: This also does not explain the presence of pus cells on urinalysis. 