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August 9, 2017

Global Glomerulosclerosis: Obsolescent Pattern

The image shows two globally sclerotic glomeruli exhibiting the so-called “obsolescent” pattern of glomerular sclerosis. The two key histologic features in this pattern are the shrunken and retracted glomerular capillary tuft (arrowhead) and the fibrous matrix which replaces Bowman’s space (arrow). This pattern of sclerosis is thought to result from reduced glomerular perfusion secondary to arteriosclerosis of small renal arteries. In contrast, the so-called “solidified” pattern of glomerular sclerosis (not shown), in which the entire remnant glomerulus is replaced by fibrous matrix, shows the strongest association with underlying APOL1 risk variants in the setting of chronic kidney disease.