Here is an example of renal vascular disease known as benign nephrosclerosis. It is called "benign" because renal function is minimally affected or proceeds to chronic kidney injury slowly. The smaller arteries in the kidney have become thickened and narrowed. Hyaline arteriolosclerosis is often present in association with "essential" hypertension or diabetes mellitus. There is patchy ischemic atrophy with focal loss of renal parenchyma that gives the surface of the kidney the characteristic granular appearance as seen here.