A 63-year-old man was admitted to the Wadsworth Veterans Administration Hospital for evaluation of azotemia and hypertension. The patient had been in apparent good health until one year earlier, when studies during a hospitalization elsewhere revealed a serum creatinine of 5.2 mg/dl, a BUN of 45 mg/dl, and 3+ proteinuria. An intravenous pyelogram was within normal limits. Hypertension was noted on admission and antihypertensive medications were given. The patient subsequently was lost to follow-up. Forty years previously the patient had been hospitalized because of transient gross hematuria of unknown cause.