患儿女，11岁，水肿伴烟灰色尿3周，经抗感染及对症支持治疗效果差，尿量进行性减少。BP140/90mmHg,尿常规Pro(+),RBC15-20个/HP,血BUN38.5mmol/L，血Cr578.6umol/L。该患儿最可能的诊断是

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