Pathology | Renovascular Disease - [click on image(s) below]
Benign Hypertension
The term "benign hypertension" is usually slight to moderate severity and of long duration; it does not imply etiology, although most often it is considered “essential” hypertension.
Benign nephrosclerosis is the term applied to the renal changes seen with long-standing benign hypertension
Gross: kidneys are normal size or slightly shrunken; external surface is granular (shown on left); sectioning reveals thinning of the renal cortex without evidence of medullary or calyceal scarring (as might be seen with pyelonephritis)
Histologic features:
hyalinization and thickening of the vessel walls results in narrowing of the arteriolar lumina (shown on right)
patchy ischemia can lead to scarring of the glomeruli and atrophy/ hypertrophy of the tubules (alternating areas of very small and very large tubules)
Benign hypertension by itself rarely causes renal insufficiency or uremia, although there may occasionally be mild proteinuria.
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