A 27-year-old man presented with 2 days of facial and hand swelling. He first noticed swelling around his eyes 2 days ago, along with difficulty putting on his wedding ring because of swollen fingers. Additionally, he noticed that his urine appears reddish-brown and that he has had less urine output over the last several days. He has no significant medical history. His only medication is ibuprofen which he took 2 weeks ago for fever and a sore throat, which have since resolved.
Examination He is afebrile, with heart rate 85 bpm and blood pressure 172/110 mm Hg He has periorbital edema Funduscopic examination is normal without arteriovenous nicking or papilledema. Chest is clear to auscultation, his heart rhythm is regular with a nondisplaced point of maximal impulse (PMI), and he has no abdominal masses or bruits. He has edema of feet, hands and face. A dipstick urinalysis shows…
