Inclusion Criteria:

- Between ages 40 and 80 years old.

- Patients with hypertension (BP>140/90 mmHg) and/or requirement for two or more antihypertensive medications for more than 4 weeks.

- Serum creatinine under 2.2 and 2.0 mg/dL for men and women, respectively (Caucasians). Values for African-American subjects are slightly higher (2.4 mg/dL, males; 2.1 mg/dL females).

- No contraindications to angiography: severe contrast allergy.

- No contraindications to no-contrast MR evaluations: e.g. pacemaker or magnetically active metal fragments, claustrophobia.

- Patients have the ability to comply with protocol.

- Patients are competent and able to provide written informed consent.

Exclusion Criteria:

- Patient has serum creatinine >2.2 mg/dL for men and >2.0 mg/dL for women (Caucasians); >2.4 mg/dL for men and >2.1 mg/dL for women (African American).

- RVD in a solitary kidney.

- Patients have clinically significant medical conditions within the prior six months; e.g., myocardial infarction, congestive heart failure, stroke, that would, in the opinion of the investigators, compromise the safety of the patient.

- Uncontrolled hypertension (Systolic BP > 180 mmHg despite therapy).

- Diabetes requiring insulin or oral hypoglycemic medications.

- Evidence of hepatitis B or C, or HIV infection.

- Requirement for potentially nephrotoxic drugs; e.g., non-steroidal anti-inflammatory drugs.

- Cardiac ejection fraction less than 30%.

- History of deep venous thrombosis within 3 months of enrollment.

- Kidney transplant.

- Pacemaker, implantable defibrillator or other contraindication to MRI.

- Inability to comply with breath-hold for 20 seconds

- Any active malignancy and undergoing therapy.

- Patients are pregnant.

- Kidney or ureteric stone.

- Another known acute or chronic kidney disease.

- Federal medical center inmates.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 7/10/23. Questions regarding updates should be directed to the study team contact.