What is hypertensive nephrosclerosis?

　　Hypertensive nephropathy (or "hypertensive nephrosclerosis", or "Hypertensive renal disease") is a medical condition referring to damage to the kidney due to chronic high blood pressure.
　　It should be distinguished from "renovascular hypertension" (I15.0), which is a form of secondary hypertension.

　　In the kidneys, as a result of benign arterial hypertension, hyaline (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, producing the thickening of their walls and the narrowing of the lumens - hyaline arteriolosclerosis. Consequent ischemia will produce tubular atrophy,interstitial fibrosis, glomerular alterations (smaller glomeruli with different degrees of hyalinization - from mild to sclerosis of glomeruli) and periglomerular fibrosis. In advanced stages, renal failure will occur. Functional nephrons have dilated tubules, often with hyaline casts in the lumens.

　　The diagnosis of hypertensive nephrosclerosis is dependent on the exclusion of other primary renal diseases. A careful past history, family history, search for signs for target organ damage, such as left ventricular hypertrophy and hypertensive retinal changes, careful urine microscopy, measurement of 24-h urinary protein and performance of renal ultrasound should establish the diagnosis, with additional tests for glomerulonephritic or vasculitic diseases if indicated.