Right renal artery !

The right renal artery carries blood from the aorta to the right kidney; it passes behind the inferior vena cava and is longer than the left.

Official name: Renal artery

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What it is

Leaves the side of the aorta at L1-L2 and passes behind the inferior vena cava to the right kidney, so it is longer than the left; it divides into segmental branches.

What it does

Brings the right kidney its share of about a fifth of all the blood the heart pumps.

Key facts

Origin: Right side of the aorta at about L1–L2, just below the SMA; longer than the left, it passes behind the IVC
Branches: Anterior and posterior divisions giving 5 segmental arteries; inferior suprarenal and ureteric branches
Supplies: Right kidney, part of the right adrenal, upper ureter (varies: accessory renal arteries in about 25–30%)

Relations

Course: From the abdominal aorta it passes to the right behind the inferior vena cava and the right renal vein, then on to the hilum, dividing into anterior and posterior divisions
In front: Inferior vena cava, right renal vein, head of the pancreas and the second part of the duodenum
Behind: Right crus of the diaphragm and psoas major

How to find it

Not palpable. At open or laparoscopic surgery it is reached behind the inferior vena cava, either by lifting the cava or through the gap between the cava and the aorta; at the hilum it lies between the renal vein in front and the renal pelvis behind.

Examination

Auscultation over the epigastrium or flank: a bruit, especially one that continues into diastole, suggests renal artery stenosis

On imaging

Duplex Doppler shows a high peak velocity at a narrowing and, further on, a damped intrarenal waveform; CT or MR angiography maps the stenosis and any accessory or precaval arteries.

Common problems

Renal artery stenosis: a narrowing that can cause high blood pressure.

Clinical notes

A narrowed renal artery lowers kidney perfusion, triggering renin release and renovascular hypertension (Goldblatt mechanism)
Because it runs behind the vena cava, in right nephrectomy it is reached by retracting the cava or between the cava and the aorta; the artery is tied before the vein
Fibromuscular dysplasia can also affect other arteries, notably the carotid and vertebral arteries, so finding it here prompts a look elsewhere

Anatomical variants

Accessory renal arteries in at least about 30%, often to the lower pole
Precaval course of an accessory or main right renal artery, in front of the inferior vena cava

Development

The kidney starts low in the pelvis and climbs to the lumbar region, picking up new arteries from the aorta as it rises while the lower ones normally fade; the ones that persist become accessory or polar renal arteries.

Test yourself

Think of the answer, then tap the question to see it.

What is the course of the right renal artery, and why is it longer than the left?

From the aorta at about L1–L2, just below the SMA, it passes to the right behind the inferior vena cava and right renal vein to the hilum, which makes it longer.

What are the two main causes of renal artery stenosis?

Atherosclerosis at the origin in older people, and fibromuscular dysplasia (beaded mid and distal segment) in young women.

How does renal artery stenosis cause hypertension?

Lower kidney perfusion triggers renin release, giving renovascular hypertension (Goldblatt mechanism).

Which examination finding suggests renal artery stenosis?

A bruit over the epigastrium or flank, especially one that continues into diastole.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): arteria renalis TA2 4269
Official Spanish (DeCS): Arteria renal DeCS D012077
English (TA2): Renal artery

Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis, Renal Artery; Anatomy of the Human Body (20th ed.): The Abdominal Aorta (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.