The renal arteries are paired arteries that supply the kidneys with blood. Each is directed across the crus of the diaphragm, so as to form nearly a right angle.
The renal arteries carry a large portion of total blood flow to the kidneys. Up to a third of total cardiac output can pass through the renal arteries to be filtered by the kidneys.
The renal arteries normally arise at a 90° angle off of the left interior side of the abdominal aorta, immediately below the superior mesenteric artery.[1] They have a radius of approximately 0.25 cm,[2] 0.26 cm at the root.[3] The measured mean diameter can differ depending on the imaging method used. For example, the diameter was found to be 5.04 ± 0.74 mm using ultrasound but 5.68 ± 1.19 mm using angiography.[4][5]
Due to the anatomical position of the aorta, the inferior vena cava, and the kidneys, the right renal artery is normally longer than the left renal artery.[1][6]
Before reaching the hilus of the kidney, each artery divides into four or five branches. The anterior branches (the upper, middle, lower and apical segmental arteries) lie between the renal vein and ureter, the vein being in front, the ureter behind. The posterior branches, which are fewer in number and include the posterior segmental artery, are usually situated behind the ureter.[7]
One or two accessory renal arteries are frequently found, especially on the left side since they usually arise from the aorta, and may come off above (more common) or below the main artery. Instead of entering the kidney at the hilus, they usually pierce the upper or lower part of the organ.
The arterial supply of the kidneys is variable and there may be one or more renal arteries supplying each kidney.[1] It is located above the renal vein. Supernumerary renal arteries (two or more arteries to a single kidney) are the most common renovascular anomaly, occurrence ranging from 25% to 40% of kidneys.[8] Aberrant renal arteries may be present, and may complicate surgical procedures.[9]
Renal artery stenosis, or narrowing of one or both renal arteries will lead to hypertension as the affected kidneys release renin to increase blood pressure to preserve perfusion to the kidneys. RAS is typically diagnosed with duplex ultrasonography of the renal arteries. It is treated with the use of balloon angioplasty and stents, if necessary.
Atherosclerosis can also affect the renal arteries and can lead to poor perfusion of the kidneys leading to reduced kidney function and, possibly, renal failure
^ abcListmann, Mishan; Tubbs, R. Shane (2020-01-01), Tubbs, R. Shane; Iwanaga, Joe; Oskouian, Rod J.; Moisi, Marc (eds.), "Chapter 19 - The Abdominal Aorta", Surgical Anatomy of the Lateral Transpsoas Approach to the Lumbar Spine, St. Louis: Elsevier, pp. 185–188, ISBN978-0-323-67376-1, retrieved 2021-01-13
^Coello-Torà, Iris; Segura-Sampedro, Juan José; Pérez-Celada, Judit; Jiménez-Morillas, Patricia; Morales-Soriano, Rafael (January 2020). "[Accessory renal artery arising from infrarenal aorta, exposed during linphadenectomy due to cytoreductive surgery and HIPEC.]". Archivos Espanoles de Urologia. 73 (1): 76–77. ISSN0004-0614. PMID31950928.
^Kaufman, John A. (2004-01-01), Kaufman, JOHN A.; Lee, MICHAEL J. (eds.), "CHAPTER 12 - Renal Arteries", Vascular and Interventional Radiology, The Requisites, Philadelphia: W.B. Saunders, pp. 323–349, ISBN978-0-8151-4369-7, retrieved 2021-01-13
This article incorporates text in the public domain from page 610 of the 20th edition of Gray's Anatomy (1918)
