why would you predict that females in species with internal fertilization and long periods of gestation would be choosier in selecting their males than females in other species

Im not sure but i did find this patient is most likely to be suffering from diabetic nephropathy.

Explanation:

Three major histological changes occur in the glomeruli of pateints with diabetic nephropathy. First, mesangial expansion is directly induced by hyperglycaemia, possibly through increased matrix production or glycation of matrix proteins. Second, thickening of the glomerular basement membrane (GBM). Third, glomerular sclerosis is caused by intraglomerular hypertension (brought by dilatation of the afferent renal artery or from ischemic injury induced by hyaline narrowing of the vessels supplying the glomeruli).  The important change in diabetic glomerulopathy is increase of extracellular matrix. The earliest morphological anomaly in diabetic nephropathy is the thickening of the glomerular basement membrane and expansion of the mesangium due to the accumulation of extracellular matrix.