These children should have the following tests: Comprehensive metabolic panel Complete blood count Urinalysis Urinary albumin: creatinine ratio Plasma renin activity and aldosterone levels Thyroid function tests Evaluation of catecholamine activity (eg, by measuring plasma free metanephrines) Renal ultrasonography with Doppler flow Echocardiography The other option for these children is an early referral to a pediatric nephrologist because most of the common causes of secondary hypertension in children are kidney related.