Abstract
To investigate the etiologic mechanism of the development of benign nephrosclerosis, kidney weight, the degree of glomerular scarring, the degree of stenosis and hyalinization in the renal small arteries and arterioles were quantitatively determined in 222 autopsies, who were followed up in the 10 years 1961 thruogh 1971 in Hisayama Study. They were analyzed in relation to age at time of death, ante-mortem blood pressure level, results of glucose tolerance test and proteinuria.
Results obtained were as follows;
1) Glomerular scarring and the stenosis of small arteries became prominent with increasing age accompaning a reduction in kidney weight, and they were more marked in hypertensive than in normotensive group at each decade. The stenosis and hyalinization of arterioles were always affected by hypertension, but they had no relation in aging process.
2) Arteriolar nephrosclerosis constantly developed in diastolic hypertensive persons without relation in age, but arterial nephrosclerosis was found in older age group independently of blood pressure level. The persistent high blood pressure had effect on the development of nephrosclerosis.
3) Four cases of severe diabetic glomerulosclerosis were observed in 35 autopsies with diabetes mellitus, most of which were latent chemical. Glomerular scarring and arteriolar hyalinization were prominent in diabetic than in control group.
4) Slight or intermittent proteinuria was noted more eminent with increasing age, and more frequent in hypertensive than in normotensive group. Persistent proteinuria was found only in diabetic nephrosclerosis.
5) The prognosis of benign nephrosclerosis was affected by complicated cerebrovascular disease. But there was no case, which terminated to death caused by nephrosclerosis.
