300 hypertensive children, from newborn to 18 years old,were studied, retrospectively, from 1975 to 1992, 105 from those lost for follow-up. In 244 the diagnosis of the primary disease, predominantly glomerulopathy, was established. 122 had chronic renal failure (CRF). From them, 74 arrived at end stage renal disease (ESRD) and 13 have been transplanted. From 12 submitted to surgical treatment, hypertension has been controlled in 8. 54 died, 48 with CRF and 38 with ESRD. Difficulties in controlling those patients are discussed, mainly therapy diet, the use of hypotensive drugs on dialysis treatment. Our conclusion is for the necessity of a precocious diagnosis for hypertension and primary diseases, of a trained interprofessional team as well as availability of adequate equipment to children, mainly for dialytic therapy. For many of these children, renal transplantation is the only definite therapy.