<prompt> A 64-year-old woman with type 2 diabetes for 10 years now develops increasing fatigue, dyspnea, and pedal edema. On examination, her blood pressure is 16590 mmHg, pulse 90min, JVP is 4 cm, heart sounds are normal, lungs are clear, and there is 3 pedal edema.Her urinalysis is positive for 3 gmL of protein and no casts or red blood cells. An abdominal ultrasound reveals normal size kidneys and no hydronephrosis. Which of the following renal diseases is the most likely diagnosis in this patient?acute glomerulonephritis GNobstructive uropathyglomerulosclerosis with mesangial thickeningrenal infarction  <response>: The patient is most likely to develop glomerulosclerosis. This can be diffuse or nodular Kimmelstiel-Wilson nodules. Poor metabolic control is probably a major factor in the progression of diabetic nephropathy. Acute GN is unlikely given the lack of casts or red cells in the urine, and patients with renal infarction usually provide a history of flank pain andor hematuria. The ultrasound results argue against obstructive uropathy and PCKD. 