Right renal artery

At a glance

English

Right renal artery

Latin (TA2)

Arteria renum dextra

System

Artery

Region

Trunk

Side

Single, on the midline

About the right renal artery

The right renal artery is the aortic branch that supplies the right kidney. It leaves the right side of the abdominal aorta at about the level of the disc between the first and second lumbar vertebrae, just below the superior mesenteric artery, and runs outwards almost at a right angle. The two renal arteries between them take a large share of the blood pumped by the heart, about a fifth to a quarter at rest, which reflects the volume of blood the kidneys filter.

Because the aorta lies to the left of the midline and the right kidney sits a little lower than the left, the right renal artery is longer than its partner and usually runs slightly downwards. It crosses the right crus of the diaphragm and psoas major and runs posterior to the inferior vena cava, which makes it the only major aortic branch to go behind that vein. Further out, the right renal vein, the pancreatic head and the second part of the duodenum all lie in front of it.

Close to the hilum it divides into an anterior and a posterior division. The anterior division, passing between the renal vein and the renal pelvis, gives the apical, upper, middle and lower segmental arteries; the posterior division runs behind the pelvis as the posterior segmental artery. These segmental vessels do not join one another, so each feeds a separate segment of the kidney. Before dividing, the main stem also gives the inferior suprarenal artery and small twigs to the ureter and the fat around the kidney.

Extra renal arteries are common; they usually come from the aorta and enter the upper or lower pole directly rather than through the hilum. A lower polar artery on the right may cross in front of the ureter and press on it. Narrowing of the renal artery, by atherosclerosis or fibromuscular dysplasia, reduces flow to the kidney, which releases renin and drives up blood pressure; it can be shown on ultrasound and treated with angioplasty and a stent. In living kidney donation the right artery's passage behind the vena cava affects how the kidney is removed and joined to the recipient's vessels.

Course and supply

Arises from

Arises from the right side of the abdominal aorta at about the L1-L2 level, just below the superior mesenteric artery.

Ends in

Divides near the hilum of the right kidney into anterior and posterior divisions that give the five segmental arteries.

Supplies

Supplies the right kidney, with an inferior suprarenal branch to the suprarenal gland and twigs to the upper ureter and perirenal fat.