Objectives:   One of the most common causes of ESRD are DM, hypertension and chronic glomerulonephritis, however most centers do not try to find out the origin of hypertension/CKD but giving antihypertensive drugs.   In order to clarify the etiology of hypertension/CKD, we performed renal biopsy. Methods:   From 2014 to 2020, our clinic performed 1,300 cases of renal biopsy at OPD level without admission, of which 272 cases(20.9%) showed normal urinary findings but associated with unknown origin hypertension/CKD,when performing renal biopsy. Results:   Of the 1,300 renal biopsy patients, 272(20.9%) showed normal urinary findings when performing renal biopsies.   Biopsy results were as followa: IgAN 98 cases(36%), mild focal nonspecific GN 43 cases (15.8%), FSGS 39 cases (14.3%), diffuse MesPGN 39 cases (14.3%), podocyte disease 8 cases (2.9%), MN 6 cases (2.2%), C1q nephropathy 5 cases (1.8%), LN 4 cases (1.5%), Malignant hypertension 3 cases (1.1%), ORG 2 cases (1.7%) ,Minor changes 2 cases (1.7%), C3GN 1 case (0.3%). Conclusions:   Most patients with hypertension/CKD were associated with serious glomerulonephritis such as IgAN, diffuse MesPGN, FSGS etc. and so early detection and treatment of the original diseases of hypertension/CKD could prevent progression to ESRD.    Most patients with IgAN, MN, FSGS and diffuse MesPGN were improved by methylprednisolone pulse therapy.   Renal biopsy is mandatory in unknown origin hypertension/CKD as soon as possible before considering antihypertensive medicines