Injury to the kidney caused by mild to moderate hypertension is termed benign nephrosclerosis. It is associated with a number of histologic changes that may progress over time. Lesions are not uniformly distributed within the kidney and may show varying degrees of progression.


"Benign" refers to not being severe or "malignant" hypertension. Significant renal damage can occur as a result of this "benign" condition.

Histologic features include:

(1) hyaline sclerosis of afferent arterioles (arteriolar hyalinosis)

(2) intimal fibroelastic thickening of interlobular arteries

(3) glomerular changes (see below)

(4) focal tubular atrophy

(5) interstitial fibrosis with a patchy lymphocytic infiltrate


Glomerular changes may include:

(1) mesangial thickening

(2) juxtaglomerular cell hyperplasia

(3) wrinkling and thickening of the capillary walls

(4) thickening of Bowman's capsule with degeneration of the basement membrane

(5) accumulation of hyaline material

(6) formation of fibrous crescents with oblitation of the urinary space

(7) glomerular collapse with sclerosis


Differential diagnosis:

(1) histologic features of malignant hypertension

(2) histologic features of concurrent renal disease


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