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OBJECTIVE The pathologic nature of pediatric renal artery occlusive lesions causing renovascular hypertension has been the subject of numerous anecdotal reports. This study was undertaken to define the character of childhood renal artery stenoses. A better understanding of this disease is particularly germane given its unknown etiology and the limited success of certain contemporary treatment options. METHODS Renal artery specimens obtained during open operations in children being treated for renovascular hypertension from 2004-2016 wer