Congenital renal arteriovenous malformations

Area of Science:

• Nephrology
• Vascular Surgery
• Urology

Background:

• Congenital arteriovenous malformations (AVMs) of the kidney are uncommon vascular anomalies.
• These lesions can present with significant clinical manifestations, including hematuria and hypertension.

Purpose of the Study:

• To evaluate the clinical course and treatment outcomes of patients diagnosed with congenital renal AVMs.
• To determine appropriate management strategies, particularly regarding the necessity of nephrectomy.

Main Methods:

• Retrospective review of 15 patients with congenital kidney AVMs diagnosed between 1950 and 1984.
• Analysis of presenting symptoms, treatment interventions (nephrectomy vs. conservative management), and follow-up outcomes.

Main Results:

• The most common presenting symptoms were hematuria (93%) and hypertension (53%).
• Ten patients underwent nephrectomy; none required reoperation, but pre-existing hypertension persisted.
• Five patients were managed conservatively with observation or medication; all had microscopic hematuria and required no further therapy.

Conclusions:

• Conservative management may be suitable for patients with microscopic hematuria or controlled hypertension.
• Nephrectomy should not be solely indicated by microscopic hematuria or controlled hypertension in congenital renal AVMs.