Diagnostic Code 7507 · 38 CFR §4.115b
Arteriolar nephrosclerosis is hardening and narrowing of the small blood vessels in the kidneys, almost always caused by long-standing high blood pressure. Over time, the damaged blood vessels cannot adequately supply the kidney tissue, leading to progressive kidney function loss. For veterans, this condition commonly develops secondary to service-connected hypertension. The VA rates arteriolar nephrosclerosis under DC 7507 based on the predominant symptoms — renal dysfunction, hypertension, or heart disease — whichever gives the highest evaluation. The CFR provides that if rated under the cardiovascular schedule, the percentage rating is elevated to the next higher evaluation.
| Rating | Criteria |
|---|---|
| 0% | When rated as renal dysfunction: GFR between 60 and 89 with abnormal urine findings sustained for three consecutive months. When rated as hypertension: diastolic pressure predominantly below 100 and systolic below 160, with a history of diastolic 100 or more requiring continuous medication. |
| 10% | When rated as hypertension: diastolic pressure predominantly 100 or more, or systolic 160 or more. This rating is elevated to the next higher evaluation when rated under the cardiovascular schedule. |
| 30% | When rated as renal dysfunction: GFR between 45 and 59 sustained for three consecutive months. When rated as hypertension with cardiovascular elevation applied. |
| 60% | When rated as renal dysfunction: GFR between 30 and 44 sustained for three consecutive months. |
| 80% | When rated as renal dysfunction: GFR between 15 and 29 sustained for three consecutive months. |
| 100% | When rated as renal dysfunction: GFR below 15, requiring regular dialysis, or eligible kidney transplant recipient. |
Blood pressure readings over time showing the hypertension pattern are important. Kidney function tests (GFR, creatinine, BUN) showing progressive decline demonstrate the kidney damage. Urinalysis showing proteinuria or other markers of kidney damage adds support. Imaging showing kidney changes consistent with nephrosclerosis may be available. A nexus letter connecting hypertension-related kidney damage to service-connected hypertension establishes the chain.