A pt with hematuria and increasing creatinine levels. He has

[meenaxi]

A 30-year-old man is evaluated for hematuria and increasing creatinine levels. He has had persistent hematuria since early childhood but for the past 2 months has noticed gross hematuria. He does not have back pain, fever, or chills. His grandfather was deaf and developed end-stage renal disease at 40 years of age. The patient takes no medication.

On physical examination, temperature is 37.4 °C (99.3 °F), pulse rate is 80/min, and blood pressure is 150/90 mm Hg. The pupils are equal. Cardiac and pulmonary examinations are normal. There is no costovertebral angle tenderness, and no masses are palpable on abdominal examination. There is ankle edema.

Laboratory Studies
Hematocrit

34%
Platelets

110,000/μL (110 x 109/L)
Creatinine

2.2 mg/dL (194.52 μmol/L)
Sodium

140 meq/L (140 mmol/L)
Potassium

5 meq/L (5 mmol/L)
Chloride

106 meq/L (106 mmol/L)
Bicarbonate

20 meq/L (20 mmol/L)
C3

120 mg/dL (1200 mg/L)
C4

28 mg/dL (280 mg/L)
Urinalysis

Specific gravity 1.015, 3+ blood, 3+ protein, no acanthocytes or cellular casts

Abdominal ultrasound shows that the right kidney is 9.2 cm and the left kidney is 9 cm. There is cortical thinning and increased echogenicity. No hydronephrosis or stones are present.

Which of the following is the most likely diagnosis?

A IgA nephropathy
B Thin basement membrane disease
C Membranoproliferative glomerulonephritis
D Alport's syndrome

[meenaxi]

D..family presents w/ deafness, renal pb..