A 42 year old type I diabetic was experiencing increasing azotemia,as judged by his BUN and creatinine.His physician recommended he consult a nephrologist.A renal biopsy was recommended,and eventually performed,a representative section of which is shown in the accompanying photomicrograph.Which one of the following is the best diagnosis? 
Definitions:
Sexual Encounters
Experiences involving sexual activity or intimacy between individuals.
Spectatorship
The action of watching or observing something, especially events, performances, or activities.
Spectatoring
The mental act of observing and evaluating one's own sexual performance, which can lead to anxiety and sexual dysfunction.
Sexual Performance
Refers to the execution and quality of sexual activities, often influenced by physical, psychological, and emotional factors.
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