Renal artery
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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, 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 In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols Q, \dot Q, or \dot Q_ , edited by Catherine E. Williamson, Phillip Bennett is the volumetric flow rate of the heart's pumping output: th ...
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 ...
off of the left interior side of the
abdominal aorta In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). Structure The abdominal aorta begins at the level of the diaphr ...
, immediately below the superior mesenteric artery. 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, and the kidneys, the right renal artery is normally longer than the left renal artery. * The right passes behind the inferior vena cava, the right renal vein, the head of the pancreas, and the descending part of the
duodenum The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear, and the terms anterior intestine or proximal intestine m ...
. 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 endoc ...
and the
splenic vein The spleen is an organ found in almost all vertebrates. Similar in structure to a large lymph node, it acts primarily as a blood filter. The word spleen comes .
, 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 (SM ...
.


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 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 The inferior suprarenal artery is a paired artery that supplies the adrenal gland. It usually originates at the trunk of the renal artery before its terminal division, but with many common variations. It supplies the adrenal gland parenchyma, the ...
to the
suprarenal gland The adrenal glands (also known as suprarenal glands) are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which ...
, the ureter, 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, 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 ...
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 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