MRCP2-4093

MRCP2-4093

A 35-year-old woman who is 20 weeks’ pregnant with her second pregnancy presents for a routine antenatal check. She has a history of two hospital admissions for pyelonephritis during childhood but takes no regular medication. On examination, her blood pressure is 140/90 mmHg. It is rechecked an hour later and found to be 136/88 mmHg. No other significant abnormalities are found. The following investigations are performed:

Investigation Result Normal value
Sodium (Na+) 138 mmol/l 135-145 mmol/l
Potassium (K+) 4.0 mmol/l 3.5-5.0 mmol/l
Urea 4.2 mmol/l 2.5-6.5 mmol/l
Creatinine 130 µmol/l 50-120 µmol/l
Urinalysis NAD
Ultrasound scan, kidneys:
Right kidney BPD 11.2 cm
Left kidney BPD 6.0 cm
Left kidney Irregular outline

What is the most likely diagnosis?