A woman develops hypertension and proteinuria after recurrent urinary tract infections. What is the most likely cause of her renal abnormalities?

In this scenario, the presence of hypertension and proteinuria following recurrent urinary tract infections strongly points to the development of reflux nephropathy. Reflux nephropathy occurs when there is abnormal backflow of urine from the bladder into the ureters and potentially into the kidneys, often due to a congenital defect in the ureterovesical junction. This condition can lead to repeated infections and subsequent renal damage.

Over time, the persistent backflow and infection can result in scarring of the renal tissue, decreased renal function, and complications such as hypertension and proteinuria. The recurrent nature of the urinary tract infections in this case further supports the likelihood of reflux nephropathy as it fosters a cycle of renal injury.

In contrast, while acute pyelonephritis can cause temporary changes in kidney function and may present with similar symptoms, it is typically due to a single acute infection rather than recurrent issues leading to chronic damage. Amyloidosis primarily causes proteinuria due to deposition of amyloid proteins in the renal interstitium, but it is less likely to be linked to recurrent urinary infections. Finally, type 2 diabetes mellitus can lead to kidney damage and proteinuria, but its connection to the recent history of urinary tract infections does not provide a clear caus