问题：
[单选题]在急性肾小管坏死和急性间质性肾炎难以鉴别时，为了不延误治疗，应采取的措施是
A、抗感染治疗
B、立即开始甲泼尼龙冲击治疗
C、积极血液或腹膜透析治疗
D、尽快肾活检明确诊断
E、静脉滴注甘露醇
参考答案：
D
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