Left renal vein !

The left renal vein drains the left kidney and crosses in front of the aorta to the inferior vena cava; its length makes this kidney preferred for donation.

Official name: Right renal vein

See in 3D →

Opens in the Durgical app, no sign-up needed.

What it is

A longer vein that crosses in front of the aorta, just below the superior mesenteric artery, to reach the inferior vena cava.

What it does

Drains the left kidney and also receives the left adrenal and left gonadal veins.

Key facts

Drains: Left kidney; also receives the left gonadal, left suprarenal and left inferior phrenic veins; often a lumbar or hemiazygos communicating vein from behind
Into: IVC at about L1–L2; long, it crosses in front of the aorta just below the SMA (nutcracker compression; left varicocele)

Relations

Course: From the hilum it runs medially in front of the left renal artery, crosses in front of the abdominal aorta just below the origin of the superior mesenteric artery and enters the left side of the inferior vena cava
In front: Superior mesenteric artery (in the angle it makes with the aorta), the pancreas and the splenic vein
Behind: Left renal artery, then the abdominal aorta
Below: Third part of the duodenum, which passes through the same aortomesenteric angle a little lower

How to find it

Found at surgery crossing the front of the aorta in the angle just below the origin of the superior mesenteric artery, a landmark for the upper neck of an infrarenal aortic aneurysm; before it crosses it receives the left gonadal vein from below and the left adrenal vein from above.

On imaging

In nutcracker syndrome CT or MRI shows the vein squeezed between the aorta and the superior mesenteric artery and widened before the narrowing (beak sign); Doppler shows a velocity rise. CT before aortic or retroperitoneal surgery looks for a retroaortic or circumaortic vein.

Common problems

Nutcracker syndrome: squeezed between the aorta and the superior mesenteric artery (blood in the urine, flank pain).
Why varicoceles are more common on the left: the left testicular vein drains into it at a right angle.

Clinical notes

Nutcracker compression raises pressure in the vein and its tributaries: hematuria, left flank pain, left varicocele or pelvic congestion
Renal cell carcinoma can extend as tumour thrombus along the vein into the inferior vena cava; its level shapes the operation
Renal vein thrombosis is linked to nephrotic syndrome, classically membranous nephropathy

Anatomical variants

Retroaortic left renal vein, passing behind the aorta; squeezed against the spine it can cause posterior nutcracker
Circumaortic left renal vein (renal collar): one limb in front of and one behind the aorta; a hazard in aortic clamping
In most people a lumbar vein or a channel to the ascending lumbar and hemiazygos veins (renoazygolumbar trunk) joins its back; it is tied in left nephrectomy and is a collateral route around a blocked left renal vein or cava

Development

Forms from a venous ring around the aorta (renal collar) with a front limb from the subcardinal veins and a back limb from the supracardinal veins; normally only the front limb stays, and a persisting back limb gives a retroaortic or circumaortic vein.

Test yourself

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

What is the course of the left renal vein?

From the hilum medially in front of the left renal artery, across the front of the aorta just below the superior mesenteric artery origin, into the left side of the inferior vena cava.

Which veins drain into the left renal vein?

The left gonadal, left suprarenal and left inferior phrenic veins.

What is nutcracker syndrome?

Compression of the left renal vein between the aorta and the superior mesenteric artery: hematuria, left flank pain, left varicocele or pelvic congestion.

Which left renal vein variants pass behind the aorta, and why do they matter?

A retroaortic vein and a circumaortic vein (renal collar, one limb in front and one behind); they are a hazard in aortic clamping.

Why can the left renal vein be tied near the vena cava in aortic surgery?

The gonadal, adrenal and lumbar veins drain the kidney around the block.

Add to my cards (5)

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

Its names

Official Latin (TA2): vena renalis dextra; vena renalis sinistra TA2 5000
Official Spanish (DeCS): Venas renales DeCS D012082
English (TA2): Right renal vein
Also called: renal veins

Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis, Renal Veins; Anatomy of the Human Body (20th ed.): The Abdominal Aorta (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain; 20.5 Circulatory Pathways (OpenStax (Rice University), 2022) · adapted, CC BY 4.0; Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, sección 4: Venas (sistemas de las venas cavas superior e inferior, vena porta, venas del raquis).

Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake

Representative model, for educational purposes only.