Renal artery variations: a 20.782 kidneys review

Caryn Recto, Antonino Marcello Pilia, Riccardo Campi, Jacopo J.V. Branca, Alessandra Pacini, Ferdinando Paternostro

Introduction: vascular anatomy variations are important in academic, clinical and surgical are-as as well as nephrology, urology, oncological and vascular surgery, among others. The main objective of this review is to know the real prevalence of multiple renal arteries in a wide, mul-tiethnic population. Secondary objectives are to establish the prevalence of early branching of the renal artery and the prevalence of these variations in left and right kidneys.

Methods: this study analyzes the renal arterial anatomy of 20.782 kidneys from 64 anatomical and radiologi-cal studies.

Results: Multiple renal arteries (MRA) were present in 19,95% of the total kidneys, in number of 2 to 6 arteries arriving to the hilum. The most frequent number of MRA was 2 renal arteries (89,48%), followed by 3 (9,31%), 4 (1,06%), 5 (0,02%) and 6 (0,005%). This last one being found in only one kidney. Reported data on the lateralization of the MRA are rather poor, and among these no side’s predilection was found: MRA were found in 49,83% on the right side and 50,17% of left kidneys. Early branching patterns were described in only one third of the published data, being present in 11,4% of the total kidneys from those data (corresponding in 4,23% of right kidney cases and in 4,52% of left kidney cases; 2,66% had no right/left infor-mation).

Discussion: the most difficult part was to merge the results from the different studies due to the heterogeneity of their descriptions. A universally accepted medical nomenclature is needed in order to allow a more precise lecture and transmission of results in clinical practice. Renal anatomical variations have clinical and surgical implications in renal transplantation, cor-rectable hydronephrosis, ablation treatment for refractory hypertension or endovascular recon-structions and should be taken into account by every physician.

IJAE Vol. 124, n. 2: 153-163, 2019

Number of kidneys with MRA and its prevalence.


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