Review Question - QID 212471

A 25-year-old woman presents to her primary care physician for her annual physical exam. Her prior medical history is significant for seasonal allergies and a broken arm at age 12 that was treated in a long arm cast. She has not had any major illnesses in the previous year and does not currently have any major complaints. On physical exam her blood pressure is found to be 152/95 mmHg. Laboratory findings reveal elevated levels of renin and aldosterone. Given her elevated blood pressure, she is prescribed captopril; however, 1 week later she presents to the emergency department with a significant increase in her creatinine. At that point captopril is immediately stopped. Which of the following is the most likely cause of this patient's disorder?