Chronic renal failure in childhood is mostly caused by a congenital disorder or an acquired form of glomerulonephritis. We describe a case of a 13-year-old boy from Africa who presented with a cerebrovascular accident, malignant hypertension and renal insufficiency. Aetiological workup of his hypertension revealed underlying chronic renal failure due to histologically confirmed haemolytic uraemic syndrome. This case serves to remind clinicians of the serious complications of undiagnosed chronic renal failure in a child.