I can only speak generally of course and can't give specific medical advice about a case for liability reasons. However, in general, with normal sized kidneys and very high grade proteinuria, despite a history of hypertension as a possible explanation, I think one needs to exclude a primary glomerulonephritis. Having said this, it is very possible that severe hypertension alone is causing this presentation. As well, prior to biopsy, of course, BP needs to be well controlled.
I would definitely like to hear what happens with this case.