问题描述：
[单选]
一名58岁的男子表现出呼吸困难，他报告在过去的三个月中由于恶心，呕吐和呼吸困难而感到不适。 您会发现他的脚踝肿胀，胳膊上有瘀伤。 病人说他没有像平常那样排尿。 最合适的调查是：A 58-year-old man presents with breathlessness， he reports feeling unwell over the last three months with nausea， vomiting and difficulty breathing． You notice his ankles are swollen and he has bruises on his arms． The patient mentions he has not been urinating as often as normal． The most appropriate investigation is:
A．血清电解质，尿素和肌酐Serum electrolytes, urea and creatinine
B．肾超声 Renal ultrasound
C．尿液镜检Urine microscopy
D．肾活检Renal biopsy
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