The existence of a relationship between the kidney and arterial hypertension has long been known. Renal participation in the development of arterial hypertension has been clearly shown in different animal models that mimic human essential hypertension. Some data obtained in hypertensive humans also seem to support the prevalence of the kidney in the initiation of this particular type of arterial hypertension. On the other hand, renal vasculature can also suffer the consequences of essential hypertension and, as a result, chronic renal failure can develop. The role of antihypertensive therapy in preventing renal damage has been sufficiently addressed. However, investigation of the potential for facilitating the antihypertensive capacity of drugs through their renal effects and investigation of the differing abilities of particular groups of antihypertensive agents to prevent or slow the progression of renal damage constitutes a challenge for future research.