Kidney Research and Clinical Practice 2018 Mar; 37(1): 94-95  https://doi.org/10.23876/j.krcp.2018.37.1.94
Incidentally discovered renal arteriovenous malformation
Jeong-Hoon Lim1, Sang Yup Lee2, Hyejin Cheon2, and Yong-Lim Kim1
1Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea, 2Department of Radiology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
Correspondence to: Yong-Lim Kim, Division of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. E-mail: ylkim@knu.ac.kr. ORCID: http://orcid.org/0000-0002-1344-3455
Received: October 25, 2017; Accepted: October 27, 2017; Published online: March 31, 2018.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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A healthy 42-year-old woman presented proteinuria and hematuria on regular medical check-up two years ago. Her other laboratory examinations did not show any abnormal findings, including renal function, anti-neutrophil antibody, anti-neutrophil cytoplasmic antibody, C3, C4, or immunoglobulin. Her blood pressure was also normal. Because flank pain had developed, color Doppler ultrasound of the kidney was performed. There was a 2-cm-sized renal cyst with blood flow in the right kidney (Fig. 1). Computed tomography angiography and renal angiography demonstrated it to be a renal arteriovenous malformation (RAVM) (Fig. 1, 2). Based on the size of the malformation, its location, and symptoms of the patient, we planned elective endovascular treatment. Successful selective embolization with 5 coils was done, and she was discharged the day after without any complications.

RAVMs are an unusual disease with a prevalence less than 0.04%. It may or may not manifest symptoms, such as flank pain, hematuria, hypertension, and flank bruit. When patients show these kinds of symptoms, RAVMs should be considered, and image studies should be performed. Compared with surgical treatment, transcatheter arterial embolization can reduce complications and length of hospital stay and could be considered as the treatment of choice for RAVMs.

Conflicts of interest

All authors have no conflicts of interest to declare.

Figures
Fig. 1. Left column shows ultrasound images, and right column shows computed tomography angiography images. (A–D) Before endovascular treatment. (E–F) After endovascular treatment.
Fig. 2. (A, B) Before endovascular treatment. (C, D) After endovascular treatment.


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