Hypertensive nephropathy
Encyclopedia
Hypertensive nephropathy (or "hypertensive nephrosclerosis", or "Hypertensive renal disease") is a medical condition referring to damage to the kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

 due to chronic high blood pressure.

It should be distinguished from "renovascular hypertension
Renovascular hypertension
Renovascular hypertension is a syndrome which consists of high blood pressure caused by narrowing of the arteries supplying the kidneys...

" (I15.0), which is a form of secondary hypertension
Secondary hypertension
Secondary hypertension is a type of hypertension which by definition is caused by an identifiable underlying secondary cause. It is much less common than the other type, called essential hypertension, affecting only 5% of hypertensive patients. It has many different causes including endocrine...

.

In the kidneys, as a result of benign arterial hypertension, hyaline
Hyaline
The term hyaline denotes a substance with a glass-like appearance.-Histopathology:In histopathological medical usage, a hyaline substance appears glassy and pink after being stained with haematoxylin and eosin — usually it is an acellular, proteinaceous material...

 (pink, amorphous, homogeneous material) accumulates in the wall of small arteries and arterioles, producing the thickening of their walls and the narrowing of the lumina
Lumen (anatomy)
A lumen in biology is the inside space of a tubular structure, such as an artery or intestine...

 — hyaline arteriolosclerosis
Arteriolosclerosis
Arteriolosclerosis is a form of cardiovascular disease affecting the small arteries and arterioles.Types include hyaline arteriolosclerosis and hyperplastic arteriolosclerosis, both associated with vessel wall thickening and luminal narrowing that may cause downstream ischemic injury...

. Consequent ischemia
Ischemia
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...

 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
Renal failure
Renal failure or kidney failure describes a medical condition in which the kidneys fail to adequately filter toxins and waste products from the blood...

 will occur. Functional nephrons have dilated tubules, often with hyaline casts
Urinary casts
Urinary casts are cylindrical structures produced by the kidney and present in the urine in certain disease states. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.They form via precipitation...

in the lumens. Additional complications often associated with hypertensive nephropathy include glomerular damage resulting in proteinuria and hematuria.

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