Prevalence and Relevance of Multiple Renal Arteries: A Radioanatomical Perspective

Background: A single renal artery supplies the kidney in 70% of the population but variation exists in the remaining 30%. Multiple renal arteries (MRA) in different permutations and combinations are one of the many forms of variants. Lack of awareness of multiplicity could have detrimental effects on the outcome of renal surgery. The present study aims at identifying the variants of renal artery based on its origin, multiplicity, and portal of entry in a cohort of people belonging to Southern India and its clinical implications thereof. Methods: Multi-detector CT (MDCT) images of renal vasculature of 100 kidneys from 50 live kidney donors who attended the Department of Nephrology of our institution, from 2016 to 2018 were collected and studied for variations in renal arterial anatomy. Results: Out of the 18% of kidneys observed with multiple renal arteries, 88.8% had double renal arteries (DRA) and 11.1% had triple renal arteries (TRA). Common types of the double renal arteries were - two hilar arteries (31.3%) and one hilar with one inferior polar artery (IPA, 31.3%). Triple renal arteries types - 50% with one hilar, one superior polar, and one inferior polar; 50% with two hilar and one inferior polar artery. No statistically significant association was noted between the incidence of multiple renal arteries and its laterality (p-value=0.193). Conclusion: A thorough understanding of the renal artery variants is crucial for safe and efficacious uro-radiological interventional procedures.