CLINICAL IMPLICATIONS OF ACCESSORY RENAL ARTERIES: A CASE REPORT

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2019-03-05

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Nguyen, David
Vo, Russell
Lee, Janet
Kichena, Sanketh
Nwachukwu, Dexter
Kway, Kristi
Lammers, Cara
Mirochnitchenko, Alissa
Fisher, Cara

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Abstract

The kidneys are paired retroperitoneal organs that receive 20-25% of cardiac output and function in the filtration of blood and maintenance of homeostasis. In 70% of the population, each kidney is perfused by a single renal artery that branches off the abdominal aorta at L1-2 vertebrae. This leaves 30% of individuals with either accessory or aberrant renal arteries. (1) Accessory renal arteries are auxiliary to the main renal artery and both travel together through the hilum to perfuse the kidney. Meanwhile aberrant renal arteries are the sole source of kidney perfusion and typically branch directly from the abdominal aorta, entering the kidney outside of the hilum. (2) During a routine dissection of an 82-year-old female cadaver, a unilateral accessory renal artery was identified on the right side. This accessory artery was identified entering the inferior pole of the right kidney, branching directly from the anterolateral aspect of the abdominal aorta prior to its bifurcation. This accessory artery passed under the ureter and gonadal vessels. Accessory renal arteries and renal stenosis both produce similar symptoms and effects including systemic hypertension and hydronephrosis of the implicated kidney. (3) It is pertinent that these vascular anomalies be identified prior to medical procedures and surgeries such that adequate perfusion is maintained to prevent ischemia and kidney loss. Methods to identify accessory or aberrant renal arteries prior to surgical approaches, radiological interventions, and kidney transplants must be considered to prevent or mitigate the risk of complications.

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