This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
A seven year old asymptomatic girl is found to have persistant hypeension. There is no significant history and urine examination is normal. Which of the following is the most likely cause? 
Select and explain. 
A. Essential Hypeension, B. Polycystic Kidney Disease, C. Coarctation of Aoa, D. Renal Parenchymal Disease
D: Renal Parenchymal Disease
Answer: D: Renal Parenchymal Disease 
Explanation: Hypeension in children is mostly associated with renal diseases. As far as other options are concerned, essential hypeension is uncommon in children (5-10%). Persistent hypeension is an uncommon presentation of coarctation of aoa and children with polycystic kidney disease present with bilateral abdominal mass and they may also have hypeension and impaired urinary concentrating ability. Ref: Essential of Pediatrics By O P Ghai, 6TH Edition, Page 433; Harrison's Principles of Internal Medicin, 16th Edition, Page 1696