Renal arteries
Branch · L1–L2 Below SMA Right longer
Paired lateral branches arising at L1–L2, immediately below the SMA (commonly summarised as L2). The right is longer and passes behind the IVC; each enters the hilum behind the renal vein and in front of the pelvis and divides into segmental end arteries.
Traced from the start
- Abdominal aorta
- Renal arteries
Detail
- Level
- L1–L2, immediately below the SMA
- Branches
- Inferior suprarenal, ureteric, then anterior and posterior divisions giving five segmental end arteries
- Hilum order
- Front to back: vein, artery, pelvis
- Variants
- Accessory renal arteries in roughly a quarter to a third of people, usually to the lower pole
When it goes wrong
Renal artery stenosis (atheroma in older smokers; fibromuscular dysplasia in young women)
Renovascular hypertension from renin release, an abdominal bruit, and recurrent flash pulmonary oedema when bilateral; asymmetric kidney sizes on ultrasound
ACE inhibitor started in bilateral renal artery stenosis or stenosis to a solitary kidney
Efferent arteriolar dilatation collapses glomerular filtration pressure: creatinine rises by more than 30% within days; stop the drug
Renal artery occlusion (embolus, dissection flap)
Loin pain and haematuria with segmental infarction, because the segmental arteries are end arteries
Practise this structure
1 question in the bank tagged Arterial Supply.