Renal artery
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View Jeremy Jones's current disclosures- Renal arteries
- Renal artery anatomy
The renal arteries originate from the abdominal aorta and enter the renal hila to supply the kidneys. Any variant in arterial supply is important to clinicians undertaking surgery or other interventional renal procedures.
On this page:
Gross anatomy
Origin
They arise from the lateral surface of the abdominal aorta at the L1-2 vertebral body level, inferior to the origin of the superior mesenteric artery.
Course
The right renal artery courses inferior and obliquely, passing posterior to the IVC and the right renal vein to reach the renal hilum. The left renal artery is much shorter and arises slightly more superior to the right main renal artery. The left renal artery courses more horizontally, posterior to the left renal vein to enter the renal hilum. Renal arteries are between 4-6 cm in length and usually 5-6 mm in diameter.
Branches
Each renal artery gives off small branches in its proximal course, prior to dividing into dorsal and ventral rami. These branches are very small and often not visible on imaging studies:
ureteric artery
capsular artery
The dorsal and ventral rami divide into segmental branches within the renal hilum before entering the parenchyma: apical, anterior superior, anterior inferior (middle), inferior and posterior segmental renal arteries. These then divide into lobar branches which successively branch into interlobar, arcuate, and interlobular arteries. The afferent arterioles, which supply the glomeruli, originate from the interlobular arteries.
Radiographic features
Doppler ultrasound
can be technically difficult and only completed in 60% of patients
normal peak systolic velocity is 150-180 cm/s and elevation beyond this may indicate renal artery stenosis of >60% 4
normal renal arterial resistive index (RI) is ≈ 0.60
Variant anatomy
multiple/additional/accessory renal arteries: common; occur in ~25% of the population
-
early-branching (or prehilar branching): occurs in ~10% of the population
occurs within 1.5-2.0 cm of origin in the left renal artery or in the retrocaval segment of the right renal artery
important to recognize in renal transplant for successful anastomoses
precaval course
Related pathology
Quiz questions
References
- 1. Valji K. Vascular and interventional radiology. W B Saunders Co. (2006) ISBN:0721606210. Read it at Google Books - Find it at Amazon
- 2. Türkvatan A, Ozdemir M, Cumhur T et-al. Multidetector CT angiography of renal vasculature: normal anatomy and variants. Eur Radiol. 2009;19 (1): 236-44. doi:10.1007/s00330-008-1126-3 - Pubmed citation
- 3. Ozkan U, Oğuzkurt L, Tercan F et-al. Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol. 2007;12 (4): 183-6. Pubmed citation
- 4. Baxter GM. Ultrasound of the urogenital system. George Thieme Verlag. ISBN:3131374411. Read it at Google Books - Find it at Amazon
- 5. Gadabanahalli K, Bhat V. Thoracic Origin of Single Right Renal Artery: Some Interesting Facets. (2017) The International journal of angiology : official publication of the International College of Angiology, Inc. 26 (4): 264-266. doi:10.1055/s-0037-1604328 - Pubmed
Incoming Links
- Adrenal gland
- Aortoiliac occlusive disease
- Renal artery aneurysm
- Brachytherapy seed migration to the lung
- Normal radiological reference values
- Histology of blood vessels
- Abdominal aortic injury
- Adrenal arteries
- Flip-flop renal enhancement
- Renal artery stenosis
- Renal plexus
- Isolated periaortitis
- Medical abbreviations and acronyms (L)
- Testes
- Floating viscera sign
- Renal artery calcification
- Kidneys
- Fibromuscular dysplasia
- RENAL nephrometry scoring system
- End-diastolic velocity (Doppler ultrasound)
- Renal artery aneurysm
- Renal vessels (Gray's illustrations)
- Aberrant extra renal artery and vein arising from common iliac vessels
- Renal artery aneurysm causing focal hydronephrosis
- Precaval accessory right renal artery
- Normal renal Doppler ultrasound
- Spontaneous renal artery dissection
- Thoracic origin of renal artery
- Crush injury
- Aortic dissection - Stanford type B
- Renal artery pseudoaneurysm
- Aortic dissection - Stanford type B
- Aortic dissection - Stanford type A
- Bilateral accessory renal arteries with mild pelvi-ureteric junction (PUJ) obstruction
- Renal arterial supply variants (illustrations)
- Accessory renal artery
- Takayasu arteritis
- Normal CT renal artery angiogram
- Abdominal aorta - normal MRA
- Normal CT angiography of the splanchnic vessels
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