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
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 inferiorlyinferior and passesobliquely, 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
-
common; occur in ~30% of the population, bilateral in ~10%
enter the renal hilum
may arise from the aorta below (more commonly) or above the renal artery
termed aberrant renal arteries when they enter renal capsule in the upper or lower pole rather than the hilum
-
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>They arise from the abdominal aorta at the L1-2 vertebral body level, inferior to the origin of the <a href="/articles/superior-mesenteric-artery">superior mesenteric artery</a>. </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 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.</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 visible on imaging studies:</p><ul>-<li><a href="/articles/inferior-adrenal-artery">inferior adrenal artery</a></li>-<li>ureteric artery</li>-<li>capsular artery</li>- +<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>They arise from the lateral surface of the abdominal aorta at the L1-2 vertebral body level, inferior to the origin of the <a href="/articles/superior-mesenteric-artery">superior mesenteric artery</a>. </p><h5>Course</h5><p>The right renal artery courses inferior and obliquely, passing 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 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.</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 visible on imaging studies:</p><ul>
- +<li><p><a href="/articles/inferior-adrenal-artery">inferior adrenal artery</a></p></li>
- +<li><p>ureteric artery</p></li>
- +<li><p>capsular artery</p></li>
-<li>can be technically difficult and only completed in 60% of patients</li>-<li>normal <a href="/articles/peak-systolic-velocity-doppler-ultrasound">peak systolic velocity</a> is 150-180 cm/s and elevation beyond this may indicate renal artery stenosis of >60% <sup>4</sup>-</li>-<li>normal <a href="/articles/renal-arterial-resistive-index">renal arterial resistive index (RI)</a> is ≈ 0.60</li>- +<li><p>can be technically difficult and only completed in 60% of patients</p></li>
- +<li><p>normal <a href="/articles/peak-systolic-velocity-doppler-ultrasound">peak systolic velocity</a> is 150-180 cm/s and elevation beyond this may indicate renal artery stenosis of >60% <sup>4</sup></p></li>
- +<li><p>normal <a href="/articles/renal-arterial-resistive-index">renal arterial resistive index (RI)</a> is ≈ 0.60</p></li>
-<a href="/articles/accessory-renal-arteries">accessory renal arteries</a><ul>-<li>-<a href="/articles/accessory-renal-arteries"></a>common; occur in ~30% of the population, bilateral in ~10%</li>-<li>enter the renal hilum</li>-<li>may arise from the aorta below (more commonly) or above the renal artery</li>-<li>termed <em>aberrant</em> renal arteries when they enter renal capsule in the upper or lower pole rather than the hilum</li>-</ul>-</li>-<li>early-branching (or prehilar branching): occurs in ~10% of the population<ul>-<li>occurs within 1.5-2.0 cm of origin in the left renal artery or in the retrocaval segment of the right renal artery</li>-<li>important to recognise in <a href="/articles/renal-transplant">renal transplant</a> for successful anastomoses</li>- +<p><a href="/articles/accessory-renal-arteries">accessory renal arteries</a></p>
- +<ul>
- +<li><p><a href="/articles/accessory-renal-arteries"></a>common; occur in ~30% of the population, bilateral in ~10%</p></li>
- +<li><p>enter the renal hilum</p></li>
- +<li><p>may arise from the aorta below (more commonly) or above the renal artery</p></li>
- +<li><p>termed <em>aberrant</em> renal arteries when they enter renal capsule in the upper or lower pole rather than the hilum</p></li>
-<a href="/articles/thoracic-renal-artery">thoracic renal artery</a> <sup>5</sup>- +<p>early-branching (or prehilar branching): occurs in ~10% of the population</p>
- +<ul>
- +<li><p>occurs within 1.5-2.0 cm of origin in the left renal artery or in the retrocaval segment of the right renal artery</p></li>
- +<li><p>important to recognise in <a href="/articles/renal-transplant">renal transplant</a> for successful anastomoses</p></li>
- +</ul>
- +<li><p><a href="/articles/thoracic-renal-artery">thoracic renal artery</a> <sup>5</sup></p></li>
-<li><a href="/articles/renal-artery-stenosis">renal artery stenosis</a></li>-<li><a href="/articles/renal-artery-aneurysm">renal artery aneurysm</a></li>-<li><a href="/articles/renal-artery-dissection">renal artery dissection</a></li>-<li><a href="/articles/fibromuscular-dysplasia-1">fibromuscular dysplasia</a></li>-<li><a href="/articles/renal-transplant">renal transplant</a></li>- +<li><p><a href="/articles/renal-artery-stenosis">renal artery stenosis</a></p></li>
- +<li><p><a href="/articles/renal-artery-aneurysm">renal artery aneurysm</a></p></li>
- +<li><p><a href="/articles/renal-artery-dissection">renal artery dissection</a></p></li>
- +<li><p><a href="/articles/fibromuscular-dysplasia-1">fibromuscular dysplasia</a></p></li>
- +<li><p><a href="/articles/renal-transplant">renal transplant</a></p></li>
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