The glomerular capillaries may exhibit several different patterns of involvement. Some tufts appear normal, whereas others appear either segmentally or globally sclerotic. The pattern of global sclerosis may be further characterized as “obsolescence” or “solidification.” In obsolescence, there is wrinkling of the glomerular basement membrane followed by collapse of the entire glomerular tuft toward the vascular pole. The collapsed tuft becomes sclerotic, whereas the enlarged Bowman space is filled in with collagenous material. Meanwhile, in solidification, the glomerular tuft undergoes hypertrophy and then becomes globally sclerotic without collapse.

Even though hypertension is known to be associated with these histopathologic changes, an ongoing question has been whether mild to moderate hypertension induces a degree of glomerulosclerosis that results in a clinically significant loss of renal function.