A 62-year-old female presented with bilateral lower extremity edema, oliguria, nausea and vomiting, and blurred vision for 1 week. Blood pressure was 190/140 mmHg. She had facial expression rigidity and thickened hand skin. ESR was 48 mm at the end of the first hour. Urinary protein was 3 g/day, urine sediment showed RBCs 5-8/HPF, and serum creatinine was 610 μmol/L. Ultrasound revealed enlarged kidneys. The clinical diagnosis is: