The most common causes of secondary hypertension in children are Renal parenchymal disease (eg, glomerulonephritis, pyelonephritis, reflux nephropathy) or renal structural abnormalities (eg, obstructive uropathy, polycystic kidney disease, dysplastic kidneys) Renovascular disease (eg, renal artery stenosis, renal vein thrombosis) Cardiovascular disease (eg, coarctation of the aorta, arteriovenous fistula) Endocrine disease (eg, hyperthyroidism, mineralocorticoid excess, corticosteroid excess, catecholamine excess) Other causes of secondary hypertension include Sleep-disordered breathing Neurologic causes (eg, increased intracranial pressure) Drugs (eg, glucocorticoids, anabolic steroids, stimulants, oral contraceptives, nicotine, caffeine, certain illicit drugs) Psychologic stress or pain Miscellaneous causes (eg, neuroblastoma, tuberous sclerosis complex, Wilms tumor) Orthopedic-related hypertension is related to traction or casting of a lower extremity, usually after a femur fracture.