A previously healthy 54-year-old man comes to the physician because of a two-month history of intermittent hematuria and fever. He has had a 5-kg (11-lb) weight loss during this time. Prostate-specific antigen levels and prostate exam are within normal limits. Serum calcium is 11.2 mg/dL. Urine blood is 2+ on dipstick. Which of the following is the most likely diagnosis?
Diabetic glomerulosclerosis
Goodpasture syndrome
Granulomatosis with polyangiitis
Lupus nephritis
Renal cell carcinoma
Urinary tract infection
