Renal artery
Updates to Article Attributes
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.
Gross anatomy
Origin
Arises from 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 inferiorly and passes posterior to the IVC and the right renal vein to reach the renal hilum. The left renal artery is much shorter and passes more horizontally, posterior to the left renal vein to enter the renal hilum.
Branches
Each renal artery gives off small branches in its proximal course, prior to dividing into dorsal and ventral rami. These branches are branches are very small and often not visualized on imaging studies:
- inferior adrenal artery
- ureteric artery
- capsular artery
The dorsal and ventral rami divide into segmental branches which then divide into lobar branches branches. The lobar arteries successively branch into interlobar, arcuate and interlobular arteries. The afferent arterioles, which supply the glomeruli, originate from the interlobular arteries.
Radiographic appearance
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 indicated a renal artery stenosis of >60% 4
- normal renal arterial resistive index is≈ 0.60
Variant anatomy
- accessory renal arteries - are common occurring in ~30% 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 recognise in renal transplant for successful anastomoses
Related pathology
-<p>The<strong> renal arteries</strong> originate from the <a href="/articles/abdominal-aorta-1">abdominal aorta</a> and enter the renal hila to supply the <a href="/articles/kidneys">kidneys</a>. Any variant in arterial supply is important to clinicians undertaking surgery or other interventional renal procedures.</p><h4>Gross anatomy</h4><h5>Origin</h5><p>Arises from the abdominal aorta at the L1-2 vertebral body level, inferior to the origin of the superior mesenteric artery. </p><h5>Course</h5><p>The right renal artery courses inferiorly and passes posterior to the <a href="/articles/inferior-vena-cava-1">IVC </a>and the right <a href="/articles/renal-vein-1">renal vein</a> to reach the renal hilum. The left renal artery passes more horizontally, posterior to the left renal vein to enter the renal hilum.</p><h5>Branches</h5><p>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 visualized on imaging studies:</p><ul>- +<p>The<strong> renal arteries</strong> originate from the <a href="/articles/abdominal-aorta-1">abdominal aorta</a> and enter the renal hila to supply the <a href="/articles/kidneys">kidneys</a>. Any variant in arterial supply is important to clinicians undertaking surgery or other interventional renal procedures.</p><h4>Gross anatomy</h4><h5>Origin</h5><p>Arises from the abdominal aorta at the L1-2 vertebral body level, inferior to the origin of the superior mesenteric artery. </p><h5>Course</h5><p>The right renal artery courses inferiorly and passes posterior to the <a href="/articles/inferior-vena-cava-1">IVC </a>and the right <a href="/articles/renal-vein-1">renal vein</a> to reach the renal hilum. The left renal artery is much shorter and passes more horizontally, posterior to the left renal vein to enter the renal hilum.</p><h5>Branches</h5><p>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 visualized on imaging studies:</p><ul>
-</ul><p>The dorsal and ventral rami divide into segmental branches which then divide into lobar branches. The lobar arteries successively branch into interlobar, arcuate and interlobular arteries. The afferent arterioles, which supply the <a href="/articles/glomeruli">glomeruli</a>, originate from the interlobular arteries.</p><h4>Radiographic appearance</h4><h5>Doppler ultrasound</h5><ul>- +</ul><p>The dorsal and ventral rami divide into segmental branches which then divide into lobar branches. The lobar arteries successively branch into interlobar, arcuate and interlobular arteries. The afferent arterioles, which supply the <a href="/articles/glomeruli">glomeruli</a>, originate from the interlobular arteries.</p><h4>Radiographic appearance</h4><h5>Doppler ultrasound</h5><ul>
-<li>normal <a href="/articles/renal-arterial-resistive-index">renal arterial resistive</a> index is ≈ 0.60</li>- +<li>normal <a href="/articles/renal-arterial-resistive-index">renal arterial resistive</a> index is ≈ 0.60</li>
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