How Far to Look?

Abstract

As a nephrology fellow many decades ago, I orchestrated exhaustive workups, including renal arteriography, on some hypertensive children. While such investigations rarely uncovered important causes of hypertension, they were felt to be necessary in an era when the prevailing ethos was that children rarely had “essential” hypertension. Today, the clinical practice guidelines (CPG) of the AAP advise against such exhaustive investigations in children six years of age and older who have no features in their history or physical examination which would point to secondary hypertension.