Is the hypertensive urogram a necessary examination?

Twenty-four patients with surgically treated unilateral renovascular hypertension were investigated by minute sequence urography, angiography, surgical repair and pathologic examination. In only 10 patients did the urogram demonstrate evidence of the lesion. It is recommended that the hypertensive urogram not be used as a general screening device, that only selected hypertensive patients be investigated, and that the first radiologic examination in those selected patients may be renal angiography.