Benign nephrosclerosis
Encyclopedia
Benign nephrosclerosis is a term used to describe the renal changes occurring in the setting of benign hypertension
, which is always associated with hyaline arteriolosclerosis
.
in the organ served. All structures of the kidney show ischemic atrophy. In advanced cases of benign nephrosclerosis the glomerular tufts may become globally sclerosed. Diffuse tubular atrophy and interstitial fibrosis are present. Often there is a scant interstitial lymphocytic infiltrate. The larger blood vessels (interlobar and arcuate arteries) show reduplication of internal elastic lamina
along with fibrous thickening of the media (fibroelastic hyperplasia) and the subintima.
and death. However, all persons with this lesion usually show some functional impairment, such as loss of concentrating ability or a variably diminished GFR. A mild degree of proteinuria
is a frequent finding
Benign hypertension
Benign hypertension is a term used to distinguish the condition from the more acute and severe malignant hypertension. It is a condition of mild to moderate hypertension. It may be progressing at a very slow pace, and so any damage being caused may take many years to develop.Malignant hypertension...
, which is always associated with hyaline arteriolosclerosis
Hyaline arteriolosclerosis
Hyaline arteriolosclerosis, also arterial hyalinosis and arteriolar hyalinosis, refers to thickening of the walls of arterioles by the deposition of homogeneous pink hyaline material...
.
Morphology
The kidneys are symmetrically atrophic, each weighing 110-130 grams with a surface of diffuse, fine granularity that resembles grain leather. Microscopically, the basic anatomic change is the hyaline thickening of the walls of the small arteries and arterioles which is known as hyaline arteriolosclerosis. This appears as a homogeneous, pink hyaline thickening at the expense of the vessel lumina, with loss of underlying cellular detail. The narrowing of the lumen results in markedly decreased blood flow through the affected vessels, and thus produces ischemiaIschemia
In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia...
in the organ served. All structures of the kidney show ischemic atrophy. In advanced cases of benign nephrosclerosis the glomerular tufts may become globally sclerosed. Diffuse tubular atrophy and interstitial fibrosis are present. Often there is a scant interstitial lymphocytic infiltrate. The larger blood vessels (interlobar and arcuate arteries) show reduplication of internal elastic lamina
Internal elastic lamina
The internal elastic lamina or internal elastic lamella is a layer of elastic tissue that forms the outermost part of the tunica intima of blood vessels. It readily visualized with light microscropy in sections of muscular arteries, where it is thick and prominent, and arterioles, where it is...
along with fibrous thickening of the media (fibroelastic hyperplasia) and the subintima.
Clinical Course
This renal lesion alone hardly ever causes severe damage to the kidney except in susceptible populations, such as African Americans, where it may lead to uremiaUremia
Uremia or uraemia is a term used to loosely describe the illness accompanying kidney failure , in particular the nitrogenous waste products associated with the failure of this organ....
and death. However, all persons with this lesion usually show some functional impairment, such as loss of concentrating ability or a variably diminished GFR. A mild degree of proteinuria
Proteinuria
Proteinuria means the presence of anexcess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine , retrograde ejaculation, pneumaturia due to a fistula, or drugs such as pyridium.- Causes...
is a frequent finding