The renal arteries are paired arteries that supply the

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...

s with

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...

. Each is directed across the

crus of the diaphragm The crus of diaphragm (pl. crura), refers to one of two tendinous structures that extends below the diaphragm to the vertebral column. There is a right crus and a left crus, which together form a tether for muscular contraction. They take their na ...

, 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.

Structure

The renal arteries normally arise at a 90°

angle In Euclidean geometry, an angle is the figure formed by two rays, called the '' sides'' of the angle, sharing a common endpoint, called the '' vertex'' of the angle. Angles formed by two rays lie in the plane that contains the rays. Angles a ...

off of the left interior side of the abdominal aorta, immediately below the

superior mesenteric artery In human anatomy, the superior mesenteric artery (SMA) is an artery which arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies blood to the intestine from the lower part of the du ...

. They have a radius of approximately 0.25 cm, 0.26 cm at the root. 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. Due to the anatomical position of the

aorta The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes o ...

, the

inferior vena cava The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of th ...

, and the kidneys, the right renal artery is normally longer than the left renal artery. * The right passes behind the

, the right

renal vein The renal veins are large-calibre veins that drain blood filtered by the kidneys into the inferior vena cava. There is one renal vein draining each kidney. Because the inferior vena cava is on the right half of the body, the left renal vein is lo ...

, the

head of the pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...

, and the descending part of the duodenum. It’s somewhat lower than the left one. * Left artery lies behind the left renal vein, the

body of the pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...

and the splenic vein, and is crossed by the

inferior mesenteric vein In human anatomy, the inferior mesenteric vein (IMV) is a blood vessel that drains blood from the large intestine. It usually terminates when reaching the splenic vein, which goes on to form the portal vein with the superior mesenteric vein (SMV) ...

Branches

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 ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder. In a human adult, the ureters are usually long and around in diameter. The ureter is lined by urothelial cells, a type of transitional epit ...

, 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. Each vessel gives off some small inferior suprarenal branches to the suprarenal gland, the

, and the surrounding cellular tissue and muscles. 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.

Variation

The arterial supply of the kidneys is variable and there may be one or more renal arteries supplying each kidney. 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. Aberrant renal arteries may be present, and may complicate surgical procedures.

Clinical significance

Stenosis

Renal artery stenosis Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney, resulting in renov ...

, or narrowing of one or both renal arteries will lead to hypertension as the affected kidneys release

renin Renin (etymology and pronunciation), also known as an angiotensinogenase, is an aspartic protease protein and enzyme secreted by the kidneys that participates in the body's renin–angiotensin–aldosterone system (RAAS)—also known as the r ...

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

Atherosclerosis Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheromatous plaque. At onset there are usually no s ...

can also affect the renal arteries and can lead to poor perfusion of the kidneys leading to reduced kidney function and, possibly,

renal failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...

Trauma

A renal artery is damaged in 4% of blunt traumas and 7% of penetrating traumas to the

abdomen The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...

Additional images

File:Volume rendered CT scan of abdominal and pelvic blood vessels (smaller).gif, Volume rendered CT scan of abdominal and pelvic blood vessels. File:Gray1123.png, The posterior surfaces of the kidneys, showing areas of relation to the parietes. File:Slide4nn.JPG, Renal artery File:Slide7pp.JPG, Renal artery File:Slide10iii.JPG, Renal artery File:Slide2kkk.JPG, Renal artery

References

External links

* * - "Posterior Abdominal Wall: Branches of the Abdominal Aorta" {{Authority control Arteries of the abdomen