Glomerular Diseases USMLE Step 1 Practice Question

A 55-year-old man with a 10-year history of type 2 diabetes and hypertension presents with nephrotic-range proteinuria and progressive renal dysfunction. Current vitals: BP 158/92 mmHg, HR 88, RR 16, SpO2 98% on room air. Labs reveal serum creatinine 2.1 mg/dL and urine protein 4.2 g/24 hours. Renal biopsy demonstrates nodular glomerulosclerosis with mesangial matrix expansion and hyaline deposits in afferent arterioles. No immune complex deposition is noted on immunofluorescence. Which histopathologic feature is most characteristic of this patient's underlying renal disease?