Congenital renal arteriovenous malformations.

Congenital arteriovenous malformations are rare lesions of the kidney. We evaluated the clinical course of 15 patients with this lesion who were seen between 1950 and 1984. There were 9 women and 6 men, and the median age at diagnosis was 48 years. Patients presented most commonly with hematuria (93 per cent) or hypertension (53 per cent). Of the 15 patients 10 underwent nephrectomy because of gross hematuria or the perceived risk of significant bleeding, or in an effort to control hypertension. None of the 10 patients has required a further operation and those who were hypertensive preoperatively remained hypertensive postoperatively. The remaining 5 patients were treated conservatively, either with observation or antihypertensive medications. All 5 patients had microscopic hematuria and none has required further therapy. It would seem that neither microscopic hematuria nor controlled hypertension is an indication alone for nephrectomy.