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July 1963

Perimuscular Fibrosis of Renal Arteries With Hypertension

Author Affiliations


Associate Professor, Department of Pathology (Dr. Wood); Assistant Professor, Division of Renal Disease and Hypertension of the Department of Medicine (Dr. Borges); University of Maryland.

Arch Intern Med. 1963;112(1):79-91. doi:10.1001/archinte.1963.03860010125014

Stenosis of the main renal arteries by non-atheromatous mural fibrosis has been seen at University Hospital, Baltimore, in nephrectomy specimens from three women with hypertension, and in the opposite renal artery at autopsy of one of these patients.

Obstructive lesions in segments of large renal arteries removed during arterial reconstruction or nephrectomy from patients with hypertension have been described in increasing numbers in recent years.1-3 Six types of renal arterial changes producing obstruction were found by Mc Cormack 1 in the largest of these series and may be listed in order of frequency as atherosclerosis, stenosis by mural fibrosis, idiopathic thrombosis, segmental muscular and fibromuscular hyperplasia, dissecting aneurysm of the renal artery, and idiopathic stenosis.

Sections of renal arteries were examined from 15 out of 23 patients reported by Hunt, Harrison, Kincaid, Bewalz, and Davis.2 Fibromuscular stenosis was seen in 12 cases, intimal fibrous stenosis in 2, and