Home About us Current issue Ahead of Print Back issues Submission Instructions Advertise Contact Login   

Search Article 
Advanced search 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 1968 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 

Table of Contents   
Year : 2017  |  Volume : 28  |  Issue : 2  |  Page : 292-297
Anatomical study of renal and accessory renal arteries

1 Department of Anatomy, Grant Government Medical College, Mumbai, Maharashtra, India
2 Department of Anatomy, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India

Click here for correspondence address and email

Date of Web Publication23-Mar-2017


In recent years, more conservative methods of surgery of the renal artery are coming up. Hence, a precise knowledge of renal vasculature has become a necessity. Knowledge of the existence of accessory renal arteries is important; otherwise, they may get inadvertently damaged during renal surgery. Furthermore, their presence must be considered while evaluating a donor’s kidney for possible renal transplantation. The study may also be useful to clinicians performing invasive techniques, vascular surgeries, other uro-radiological procedures, and in cases of trauma. Keeping this in mind, this study was conducted on 530 adult cadavers. A total of 1060 kidneys obtained from these cadavers were dissected and accessory renal arteries were looked for; 24.99% of the specimens showed the presence of accessory renal arteries. In 20.75%, one accessory renal artery was found, and in 4.24% of specimens, two accessory renal arteries were seen.

How to cite this article:
Jamkar AA, Khan B, Joshi DS. Anatomical study of renal and accessory renal arteries. Saudi J Kidney Dis Transpl 2017;28:292-7

How to cite this URL:
Jamkar AA, Khan B, Joshi DS. Anatomical study of renal and accessory renal arteries. Saudi J Kidney Dis Transpl [serial online] 2017 [cited 2022 Dec 4];28:292-7. Available from: https://www.sjkdt.org/text.asp?2017/28/2/292/202760

   Introduction Top

The advent of more conservative methods in renal surgery has necessitated a more precise knowledge of renal vasculature. Anson and Kurth[1] in 1955 have quoted “experience shows that super-numerary arteries and veins represent the rule in renal vasculature, not the exception.” Being “end arteries,” ligation or accidental injury to renal artery may lead to renal infarcts. This observation is important during renal transplants for a complete and accurate anastomosis with all the arteries of the donor kidney. Kem2 et al in 2005 have reported two relatively young patients with significant hypertension, both having an accessory renal artery. The presence of variant renal arteries may also be associated with other underlying renal pathological conditions such as hydronephrosis.

   Subjects and Methods Top

The study was based on dissection of 1060 adult cadaveric kidneys (620 male and 440 female) from Western India. Ethical Committee approval was obtained. Comprehensive dissection was carried out, and observations on the origin and course of the renal artery were made. The presence of accessory renal arteries and their relation to the main renal artery was noted. The specimens were colored by standard color code after applying gelatin suspension, and color photographs were obtained.

   Results Top

The number of renal arteries observed on the right and left side in males and females is shown in [Table 1]. When males and females were considered together, single renal artery was seen in 77.35% on the left side and in 72.64% of specimens on the right side. Similarly, two renal arteries were present in 18.86% of specimens on the left side [Figure 1] and in 22.64% of specimens on the right side [Figure 2]. Furthermore, three renal arteries were present in 3.77% of specimens on the left side, whereas the incidence on the right side was 4.71% [Figure 3].
Table 1: Incidence of renal arteries in the present study.

Click here to view
Figure 1: Specimen showing left accessory artery.

Click here to view
Figure 2: Specimen showing a right accessory artery.

Click here to view
Figure 3: Photograph showing three renal arteries on the right side.

Click here to view

The observed values were analyzed statistically. Chi-square value for the right side was 13.44, and P value was 0.0012 (P <0.05), whereas Chi-square value for the left side was 15.02, and P value was 0.0005 (P <0.05). Hence, statistically, it proved that the accessory renal arteries, number wise, are significantly more common in both right as well as the left side.

The comparison of total accessory renal arteries observed in males and females in the present study is shown in [Figure 4].
Figure 4: Incidence of accessory renal arteries in the present study.

Click here to view

The relationship of the accessory renal arteries to the main renal artery was noted and is shown in [Table 2]. Most of the accessory renal arteries were placed superiorly [Figure 5]. Some of the specimens showed both superior and inferior accessory renal arteries.
Table 2: Relation of accessory renal arteries to main renal artery.

Click here to view
Figure 5: Photograph showing a superior accessory artery.

Click here to view

   Discussion Top

The incidence of a number of renal arteries was compared with previous studies [Table 3].
Table 3: Variations in renal arteries in various studies (Figures in %).

Click here to view

According to Standring[3] and Moore and Persaud,[4] kidney receives a single renal artery in about 70% and 75% of cases, respectively. In the present study, single renal artery was observed in 74.99% of cases [Table 1]. The incidence of accessory renal artery according to Standring[3] is about 30%. In the present study, the incidence of accessory renal artery was 24.99% [Table 1]. Decker and Du Plessis[5] have quoted that there is an accessory renal artery in 15% and 20% of cases on the right and left side, respectively. When all accessory renal arteries were taken into consideration in the present study, higher figures were noted on the right side (27.35%) than on the left side (22.63%) [Table 1].

Unilateral double renal vessels were reported by Mohammed[6] in 2012. Bilateral duplication of renal vessels was reported by Bordei et al[7] in 2004 and by Mir et al[8] in 2008. The same was also observed in the present study [Figure 6]. Bilateral triple renal arteries were observed by Pestemalci et al[9] in 2009. Anson et al[10] and Reis and Esenther[11] have noted four arteries on the right as well as the left side. A maximum number of arteries were observed by Carson.[12] He has reported five arteries on the left side. In the present study, maximum of three renal arteries was found [Figure 3].
Figure 6: Photograph showing bilateral doubled renal arteries.

Click here to view

The anatomic relation of these accessory renal arteries to the main renal artery was looked for. Sykes[14] has noted that inferior accessory renal arteries are more common. However, Olsson[16] has stated that superior accessory renal arteries are common. The present study showed a higher percentage of superior accessory renal arteries [Table 2].

The diversity of vascular pattern can be explained on the basis of its development. The kidney that initially develops in the sacral region gradually ascends up. As it starts ascending, newer renal arteries start developing from the aorta. With the appearance of newer arteries, the caudal branches normally involute and disappear. A less complete reduction results in extra-renal branching or in multiple arteries arising independently from the aorta. Due to this unique character of the kidney, this unusual pattern of vascular distribution is observed.

The study conclusively proved the complex nature of renal vascular distribution in the population of Western India. This emphasizes the necessity of the knowledge of renal vasculature to a surgeon operating on the kidney. With the advent of laparoscopic renal surgeries and donor nephrectomies, it becomes mandatory for the surgeon to understand the abnormality or variations in the renal vasculature. If this is not identified, it may jeopardize the renal transplantation. The detailed information of the vasculature will reduce the chance of hemorrhage due to accidental trauma to accessory renal artery. This can avoid unwanted postoperative morbidity and mortality.

Conflict of interest:

None declared.

   References Top

Anson BJ, Kurth LE. Common variations in the renal blood supply. Surg Gynecol Obstet 1955;100:157-62.  Back to cited text no. 1
Kem DC, Lyons DF, Wenzl J, Halverstadt D, Yu X. Renin-dependent hypertension caused by nonfocal stenotic aberrant renal arteries: Proof of a new syndrome. Hypertension 2005; 46:380-5.  Back to cited text no. 2
Standring S. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 40th ed. Edinburg: Churchill & Livingstone; 2008. p. 1231, 1233.  Back to cited text no. 3
Moore KL, Persaud TV. The Developing Human – Clinically Oriented Embryology. 6th ed. Philadelphia: W.B. Saunders Co.; 1999. p. 311.  Back to cited text no. 4
Decker GA, Du Plessis DJ. Lee Mc’Gregor’s synopsis of surgical anatomy. Indian Edition. 12th ed. Bombay: K.M. Varghese Co.; 1986. p. 289-300.  Back to cited text no. 5
Mohammed AM, Abdalrasol RG, Abdalhai KA, Hamad MG. Accessory renal vessels. Acta Inform Med 2012;20:196-7.  Back to cited text no. 6
Bordei P, Sapte E, Iliescu D. Double renal arteries originating from the aorta. Surg Radiol Anat 2004;26:474-9.  Back to cited text no. 7
Mir NS, Ul Hassan A, Rangrez R, et al. Bilateral duplication of renal vessels: Anatomical, medical and surgical perspective. Int J Health Sci (Qassim) 2008;2:179-85.  Back to cited text no. 8
Pestemalci T, Mavi A, Yildiz YZ, Yildirim M,Gumusburun E. Bilateral triple renal arteries. Saudi J Kidney Dis Transpl 2009;20:468-70.  Back to cited text no. 9
[PUBMED]  [Full text]  
Anson BJ, Richardson GA, Minear WL.Variations in the number and arrangement of renal vessels- a study of blood supply of four hundred kidneys. J Urol 1936;36:211.  Back to cited text no. 10
Reis RH, Esenther G. Variations in the pattern of renal vessels and their relation to the type of posterior vena cava in man. Am J Anat 1959; 104:295-318.  Back to cited text no. 11
Carson WJ. Anomalous renal vessels and their surgical significance. West J Surg Gynecol Obstet 1932;40:597.  Back to cited text no. 12
Adachi B. Das Arteriensystem der Japaner II. Kyoto, Tokyo: Maruzen Publishing Co.; 1928. p. 73-8.  Back to cited text no. 13
Sykes D. The arterial supply of the human kidney with special reference to accessory renal arteries. Br J Surg 1963;50:368-74.  Back to cited text no. 14
Geyer JR, Poutasse EF, Cleveland MD. Incidence of multiple renal arteries on aortography. J Am Med Assoc 1962;182:120-5.  Back to cited text no. 15
Olsson CA. Campbell’s Urology. 5thed., Vol. I. Philadelphia: W.B. Saunders Co.; 1986. p. 311.  Back to cited text no. 16

Correspondence Address:
Anand A Jamkar
Grant Government Medical College, Mumbai
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-2442.202760

Rights and Permissions


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]

  [Table 1], [Table 2], [Table 3]

This article has been cited by
1 Revascularization for Renovascular Disease: A Scientific Statement From the American Heart Association
Vivek Bhalla, Stephen C. Textor, Joshua A. Beckman, Ana I. Casanegra, Christopher J. Cooper, Esther S.H. Kim, James M. Luther, Sanjay Misra, Gustavo S. Oderich
Hypertension. 2022; 79(8)
[Pubmed] | [DOI]
2 Variations in renal arteries and pelvicalyceal system: A case report
Suma Yekapppa Hottigoudar, Jakkula Akhil, Priyanka Clementina Stephen, Yogesh Ashok Sontakke
Indian Journal of Clinical Anatomy and Physiology. 2022; 9(3): 222
[Pubmed] | [DOI]
3 Fetal accessory renal arteries and other renal anomalies
DinitK Tom, PurushottamRao Manvikar, MaitreyeeMadhav Mutalik
Medical Journal of Dr. D.Y. Patil Vidyapeeth. 2021; 0(0): 0
[Pubmed] | [DOI]
4 Encountering the accessory polar renal artery during retroperitoneal lymphadenectomy
Ceyda Karadag, Ozer Birge, Mehmet Sait Bakir, Selen Dogan, Hasan Aykut Tuncer, Tayup Simsek
Clinical Case Reports. 2021; 9(1): 177
[Pubmed] | [DOI]
5 Hypothesis: Accessory renal arteries may be an overlooked cause of renin-dependent hypertension
Mario Funes Hernandez, Vivek Bhalla, Robert T. Isom
Journal of Human Hypertension. 2021;
[Pubmed] | [DOI]
6 Relationship between Accessory Renal Artery and Clinical Characteristics of Middle-Aged Patients with Primary Hypertension
Kai Kang, Yeshuo Ma, Chongfu Jia, Yunpeng Cheng, Yingchao Yang, Lixin Wang, Yinong Jiang, Yan Lu
International Journal of Hypertension. 2020; 2020: 1
[Pubmed] | [DOI]


    Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  

   Subjects and Methods
    Article Figures
    Article Tables

 Article Access Statistics
    PDF Downloaded619    
    Comments [Add]    
    Cited by others 6    

Recommend this journal