A Pain in the Bean – Analgesic Nephropathy Part 1

We recently saw a 68 y/o M with history of ibuprofen 800 mg PO daily for 12-14 years. He had been having long standing minor renal insufficiency for the last 10 years with a progressive worsening of his GFR for about 1 year. The patient was found to have proteinuria of ~ 1 gram/day. Prior to referring to nephrology clinic for he had an ultrasound which showed the following:

Right kidney is measured at 9.9 cm length 4.3 cm transverse. Mildly echogenic appearance of the cortex with
lobular contour but no gross cortical thinning. No hydronephrosis. At least two small cysts of approximately 1 cm
are seen. Left kidney measures 10.5 x 4.7 cm. There are several scattered cysts present.

What is this patient also at risk for?
A.) Nephrocalcinosis
B.) Transitional cell carcinomas along the GU tract
C.) Gout
D.) Lung Malignancy
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