In a specimen of kidney, fibrinoid necrosis is seen and onion peel appearance is also present. Most probable pathology is

Ans. b. Hyperplastic aeriosclerosis Aeriolosclerosis Hyaline Aeriolosclerosis with associated luminal narrowingdeg. These changes stem from plasma protein leakage across injured endosthelial cells, and increased smooth muscle cell matrix synthesis in response to chronic hemodynamic stressdeg. Although the vessels of elderly persons (either normo- or hypeensive) also frequently show hyaline aeriosclerosis, it is more generalized and severe in individuals with hypeensiondeg. Major morphologic characteristic of benign hypertensiondeg Also a common feature of diabetic microangiographydeg; in that case the underlying etiology is hyperglycemia-induced endothelial cell dysfunctiondeg. In nephrosclerosis due to chronic hypeension, the aeriolar narrowing of hyaline aeriosclerosis causes diffuse impairment of renal blood supply and causes glomerular scarringdeg Hyperplastic Aeriolosclerosis Occurs in severe (malignant) hypeensiondeg Vessels exhibit "onion-skin lesions," deg characterized by concentric, laminated thickening of the walls and luminal narrowing. The laminations consist of smooth muscle cells with thickened, reduplicated basement membranesdeg In malignant hypeension they are accompanied by fibrinoid deposits and vessel wall necrosisdeg (necrotizing aeriolitis)deg, paicularly in the kidney. Characteristic of malignant hypeension