Nephrosclerosis

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Classification

Benign nephrosclerosis≒Renal lesions due to benign hypertension:
Benign hypertension: controllable mild hypertension

　

Malignant nephrosclerosis≒Renal lesions due to malignant hypertension

Malignant hypertension: rapid-onset severe hypertension

　

Characteristic lesions

	Benign	Malignant
Clinical	Hypertension Trace proteinuria Microscopic hematuria Renal impairment Contracted kidney	Accelerated hypertension with renal impairment, encephalopathy, retinopathy (with hemorrage, exudataes, and papillaedema) Enlarged kidney
Histology	Hyaline change in afferent arterioles and interlobular arteries Narrow arterial lumen Arterial medial hypertropy Elastic lamina reduplication Intimal thickening of arcuate~lobular arteries GBM wrinkling-normal Capillary narrowing~collapse	Fibrinoid necrosis in afferent arterioles Edematous thickening of intima: "onion skin", "mucoid", or "myxoid" Severe narrowing of arterial lumen Normal - GBM wrinkling Fibrinoid necrosis into glomeruli Hypertrophic JG apparatus

Benign Nephrosclerosis

Hyaline change	Medial hypertrophy

Glemerular scelerosis with wrinkled capillary wall

　

Malignant Nephrosclerosis

Fibrinoid necrosis of afferent arteriole	"Onion skin" lesion

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