Hyaline arteriolosclerosis refers to thickening of the walls of arterioles by the deposition of homogeneous pink hyaline material.^[1] It is a type of arteriolosclerosis which refers to hardening of arteriolar wall. It is encountered frequently in elderly patients, whether normotensive or hypertensive, hyaline arteriolosclerosis is more generalized and more severe in patients with hypertension. It is also common as part of the characteristic microangiography in diabetes.^[2] It is often seen in kidney pathology.

Lesions reflect leakage of plasma components across vascular endothelium and excessive extracellular matrix production by smooth muscle cells secondary to the chronic hemodynamic stress of hypertension. Hyaline arteriolosclerosis is a major morphologic characteristic of benign nephrosclerosis, in which the arteriolar narrowing causes diffuse impairment of renal blood supply, with loss of nephrons.^[3] The narrowing of the lumen can decrease renal blood flow and hence glomerular filtration rate leading to renin secretion and accentuating the underlying hypertension causing a perpetuating cycle.

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