Body system: Genitourinary SystemRegulation: 38 CFR § 4.115b
Arteriolar nephrosclerosis is hardening and narrowing of the small arteries (arterioles) that supply the kidneys, most commonly caused by chronic hypertension or diabetes mellitus. The hardened vessels reduce blood flow to the kidney parenchyma, leading to progressive ischemic damage to the glomeruli and tubules, proteinuria, and gradual loss of filtration capacity. The VA rates this condition under the renal dysfunction ladder (38 CFR § 4.115a) from 0% to 100% based on Glomerular Filtration Rate (GFR) sustained over 3 consecutive months in the past 12 months, or the presence of dialysis dependence or transplant eligibility.
Rating levels
- 100% — You qualify for 100% if your arteriolar nephrosclerosis has progressed to end-stage renal disease — GFR under 15 mL/min/1.73 m² sustained for at least 3 consecutive months in the past year, OR routine dialysis dependence, OR transplant eligibility. Any one of these three pathways qualifies.
- 80% — You qualify for 80% if your arteriolar nephrosclerosis has progressed to Stage 4 chronic kidney disease — GFR of 15 to 29 mL/min/1.73 m² sustained for 3+ consecutive months in the past year.
- 60% — You qualify for 60% if your arteriolar nephrosclerosis is at Stage 3b chronic kidney disease — GFR 30-44 mL/min/1.73 m² sustained for 3+ consecutive months in the past year.
- 30% — You qualify for 30% if your arteriolar nephrosclerosis is at Stage 3a chronic kidney disease — GFR 45-59 mL/min/1.73 m² sustained for 3+ consecutive months in the past year.
- 0% — You qualify for 0% if your GFR is 60-89 mL/min/1.73 m² (Stage 2 CKD) AND you have one of three additional markers sustained for 3+ consecutive months in the past year: (a) recurrent urinary casts, (b) structural kidney abnormalities on imaging, OR (c) proteinuria with albumin/creatinine ratio of 30 mg/g or higher. The condition is recognized as service-connected but is not currently producing compensable disability.