Marked hypertension is known to have persisted for a 2½-year period in a 5-year-old child. The symptoms of polydipsia and polyuria with enuresis as well as hyperactivity had been noted. The only physical findings were hypertension and its associated retinopathy.

Attempts at translumbar aortography resulted in a large hemorrhage into the left pleural space. Two years later, however, a successful retrograde renal arteriogram revealed a stenosis of the superior branch of the right renal artery. Removal of this obstruction and re-anastomosis of the vessel resulted in the return of the blood pressure to normal as well as the complete relief of the symptoms. In the pediatric age group this is believed to be the first report of such a lesion treated successfully with vascular surgery.

On the basis of observation with this child, as well as data from the literature, it is concluded that hypertension in children is almost never essential and every effort should be made to determine the cause. Children with enuresis, or polyuria and polydipsia, should have careful blood pressure determinations.

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