A 70-year-old man with hypertension dies from a stroke. Autopsy shows bilaterally small, granular kidneys weighing 90 g each. Histology reveals hyaline arteriolosclerosis with narrowed lumens and focal ischemic glomerular obsolescence. The most accurate term for this renal disease is:
- A Malignant nephrosclerosis
- B Chronic pyelonephritis
- C Benign nephrosclerosis ✓
- D Analgesic nephropathy
Correct answer: C. Benign nephrosclerosis
Explanation
Benign nephrosclerosis is the renal pathology of longstanding benign hypertension, characterized by hyaline arteriolosclerosis of afferent arterioles leading to ischemic injury and glomerulosclerosis. Grossly, the kidneys are symmetrically contracted with a finely granular cortical surface due to patchy ischemic scarring. In contrast, malignant nephrosclerosis shows hyperplastic ('onion-skin') arteriolar changes and fibrinoid necrosis associated with hypertensive emergency.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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