The clinical courses of two older patients with progressive renal fail
ure associated with hypertension are described. Their underlying disor
ders are similar, but there are stark contrasts between medical therap
ies available now and 50 years ago. Such advances include the developm
ent of antihypertensive drugs and antimicrobial medications that have
reduced the incidence of renal failure. In addition, recombinant eryth
ropoietin. and calcitriol have decreased the morbidity associated with
chronic renal failure. Finally, technologic breakthroughs in dialysis
have made a once-fatal condition eminently treatable.