Children who are thought to have a high probability of renovascular disease, for example those with normal body mass index, no family history, elevated renin, hypertension requiring multiple medications should undergo angiography with a view to endovascular treatment regardless of findings of non-invasive imaging (Fig. 1) (Tullus et al. 2008; Louis et al. 2018; Trautmann et al. 2017; Tullus 2011). The gene discussed is REN; the disease is Hypertension.