[单选题]急性肾小管坏死和急性间质性肾炎鉴别困难时，为了不贻误治疗应当

A、尽快使用抗生素
B、立即开始用甲基强的松龙冲击治疗
C、积极透析治疗
D、尽快肾活检明确诊断
E、大量使用利尿药

参考答案： D

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