Prevalence of Anatomical Variant Renal arterial diameter, Early Prehilar Branching and Multiplicity on Contrast Enhanced Computed Tomography Scans

Prevalence of Anatomical Variant Renal arterial diameter, Early Prehilar Branching and Multiplicity on Contrast Enhanced Computed Tomography Scans

Authors

  • Shaista Arshad Jarral Department of Anatomy, CMH Lahore Medical College & Institute of Dentistry, Lahore
  • Tehreem Fatima Department of Anatomy, Services Institute of Medical Sciences, Lahore
  • Tariq Mahmood Mirza Department of Radiology, CMH Lahore Medical College & Institute of Dentistry, Lahore
  • Umar Farooq Rashid Lateef Medical College, Lahore

DOI:

https://doi.org/10.21649/akemu.v30i2.5590

Keywords:

Pre-hilar branching, Renal artery, Computed Tomography

Abstract

Background: Chronic kidney disease is a widespread condition that significantly contributes to the global disease burden, especially in South Asia and particularly in Pakistan. 

Objective: To find out the prevalence of anatomical variations of renal arteries in terms of vessel luminal diameter, early pre-hilar branching, multiple renal arteries, their laterality, and any potential correlation with gender within our population.

Methods: This was an observational, cross-sectional study using non-probability consecutive sampling of contrast-enhanced computed tomography scans of male and female subjects in age range from 18 to 80 years, with no known renal or vascular disease, conducted at the Radiology Department of Combined Military Hospital, Lahore.

Results:  The study analyzed 300 contrast-enhanced computed tomography scans, including 167 (55.7%) male and 133 (44.3%) female subjects. The mean value of luminal diameter of renal artery was 6.44±1.41 on right and 6.54±1.54 on left, but not significant association with laterality or gender. Pre-hilar branching was noted in 89 (29.8%) of subjects on the right renal artery and 144 (48%) subjects on the left renal artery. Prehilar branching in males was 58(34%) for right and 92(55%) for left side, while in the females it was 31(23%), for the right and 52(39%), for the left side. A statistically significant correlation between gender and pre-hilar branching on both the right (p = .035) and left (p = .006) sides. Bilateral prehilar branching in 61(20%) of total patients, 37(60.6%) being male and 24(39.3%) females. A supernumerary renal artery was present in 35(11.6%) of total with 17 (5.6%) in right renal and 18 (6%) in the left renal vasculature, and 22(7.3%) in males and 13(4.3%) in females (p=0.788).

Conclusion: The study showed variations in the renal artery caliber, branching pattern and the existence of accessory renal arteries within our local population. The most common variation was Presence of prehilar branching with statistically significant association with left renal artery and male gender in our study population.

References

Bikbov B, Purcell C, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017, Lancet. 2020;395(10225):709-733. Doi: 10.1016/S0140-6736(20)30045-3. Epub 2020 Feb 13. PMID: 32061315; PMCID: PMC7049905.

Hariparshad S, Bhimma R, Nandlal L, Jembere E, Naicker S, Assounga A. The prevalence of chronic kidney disease in South Africa - limitations of studies comparing prevalence with sub-Saharan Africa, Africa, and globally. BMC Nephrol. 2023;24(1):62. Doi: 10.1186/s12882-023-03109-1. PMID: 36944928; PMCID: PMC10029276.

Forbes A, Gallagher H. Chronic kidney disease in adults: assessment and management. Clinical Medicine Mar, 2020, 20 (2) 128:132; DOI: 10.7861/clinmed.cg.20.2

Khan YH, Mallhi TH, Sarriff A, Khan AH, Tanveer N. Prevalence of Chronic Kidney Disease in Asia: A Systematic Review of Population-Based Studies. JCPSP. 2018;28 (12): 960-966.

Imran S, Sheikh A, Saeed Z, Khan SA, Malik AO, Patel J, et al . Burden of chronic kidney disease in an urban city of Pakistan, a cross-sectional study. J Pak Med Assoc. 2015;65(4):366-9. PMID: 25976568.

Chhetri P, Basnet P, Adhikari A. Anatomical Variations of Renal Artery in Patients Undergoing Computed Tomography of Abdomen: A Hospital-based Cross-sectional Study. J Lumbini Med Coll [Internet]. 29Aug.2021 [cited 1Feb.2024];9(2):7 pages. Available from: https://www.jlmc.edu.np/index.php/JLMC/article/view/434

Moore KL, Persaud TVN Torchia MG. The developing Human- Clinically Oriented Embryology. 9th ed. Philadelphia, USA: Elsevier Saunders, 2013.

Abdessater M, Alechinsky L, Parra J, Malaquin G, Huot O, Bastien O,et al . Anatomical variations of the renal artery based on the surgeon's direct observation: A French perspective. Morphologie. 2022;106(352):15-22.

Mihaylova E, Groudeva V, Nedevska M. Multidetector computed tomography angiography study of the renal arterial vasculature anatomy and its variations in a Bulgarian adult population. Surgical and Radiologic Anatomy. 2023;45(3):289-96.

Tardo DT, Briggs C, Ahern G, Pitman A, Sinha S. Anatomical variations of the renal arterial vasculature: An Australian perspective. J Med Imaging Radiat Oncol. 2017;61(5):643-9.

Ferhatoğlu MF, Atli E, Gürkan A, Kebudi A. Vascular variations of the kidney, retrospective analysis of computed tomography images of ninety-one laparoscopic donor nephrectomies, and comparison of computed tomography images with perioperative findings. Folia morphologica. 2020;79(4):786-92.

Regmi PR, Amatya I, Kayastha P, Poudel S, Suwal S, Ghimire RK. Normal Anatomy and Variants of Renal Vasculature with Multidetector Computed Tomography in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA: Journal of the Nepal Medical Association. 2020;58(231):911.

Swarna, Agarwal Y, Jain S, Chawla AS. Renal vasculature: Spectrum of anatomical variations and the significance from a surgeon’s standpoint. Astrocyte. 2018; 4(1):233-9.

Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench. 2013;6(1):14-7. PMID: 24834239; PMCID: PMC4017493.

Ramadan SU, Yigit H, Gökharman D, Tunçbilek I, Dolgun NA, Kosar P, et al. Can renal dimensions and the main renal artery diameter indicate the presence of an accessory renal artery? A 64-slice CT study. Diagn Interv Radiol. 2011;17(3):266-271. Doi: 10.4261/1305-3825.DIR.3507-10.0.

Çınar C, Türkvatan A. Prevalence of renal vascular variations: Evaluation with MDCT angiography. Diagn Interv Imaging. 2016;97(9):891-7. Doi: 10.1016/j.diii.2016.04.001. Epub 2016 May 10. PMID: 27178758.

Agarwal, Aiyappan SK, Mathuram AC, Valsala NHR, Shanmugam V. Prevalence of renal vascular variations in patients subjected to contrast CT abdomen. IJCMSR. 2019;4(2): B114- B119.

Mohiuddin M, Mansoor A, Ali M, Hassan N. Analysis of renal artery morphometry in adults: A study conducted by using Multidetector computed Tomography Angiography. Pak J Med Sci. 2017;33(4):943-947. Doi: https://doi.org/10.12669/pjms.334.13063

Paudyal S, Gupta MK, Adhikari D, Shah R, Poudel B. Anatomical variations of renal artery studied by computed tomography in a tertiary care center in Nepal. Int J Health Sci Res. 2023; 13(7):268-273. DOI: https://doi.org/10.52403/ijhsr.20230738

Chhetri PK, Basnet P, Adhikari A. Anatomical Variations of Renal Artery in Patients Undergoing Computed Tomography of Abdomen: A Hospital-based Cross-sectional Study. JLMC. 2021;9(2):7-pages.

Gupta M, Kaul NV, Shukla AK. A Contrast Enhanced MDCT Study on the Morphology of Renal Vessels, Their Variations and Clinical Implications. Int J Anat Res. 2022;10(1):275-82.

Agarwal S, Aiyappan SK, Mathuram AC, Raveendran NH, Valsala VS. Prevalence of renal vascular variations in patients subjected to contrast CT abdomen. IJCMSR. 2019;4(1): B114-9.

Gulas E, Wysiadecki G, Cecot T, Majos A, Stefańczyk L, Topol M, et al. Accessory (multiple) renal arteries–Differences in frequency according to population, visualizing techniques and stage of morphological development. Vascular. 2016;24(5):531-7.

Aremu A, Igbokwe M, Olatise O, Lawal A, Maduadi K. Anatomical variations of the renal artery: a computerized tomographic angiogram study in living kidney donors at a Nigerian Kidney Transplant Center. Afr. Health Sci . 2021;21(3):1155-62.

Regmi PR, Amatya I, Kayastha P, Poudel S, Suwal S, Ghimire RK. Normal Anatomy and Variants of Renal Vasculature with Multidetector Computed Tomography in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA. 2020;58(231):911.

Mohiuddin M, Sundus S, Raza I, Kamran M, Kumar H, Mubeen S. Anatomical variants of Renal vasculature: A study in adults on multidetector Computerized Tomography angiography scan. Professional Med J 2020; 27(1):185-190.

Panta OB, Giri SR, Gurung B, Dhakal V, Ghimire RK. Renal Artery Dimensions and Variation on Computed Tomography Angiogram: A Cross-sectional Study. JNMC. 2022;6(2):25-9.

Downloads

Published

06/29/2024

How to Cite

Arshad Jarral , S., Tehreem Fatima, Tariq Mahmood Mirza, & Umar Farooq. (2024). Prevalence of Anatomical Variant Renal arterial diameter, Early Prehilar Branching and Multiplicity on Contrast Enhanced Computed Tomography Scans. Annals of King Edward Medical University, 30(2), 163–170. https://doi.org/10.21649/akemu.v30i2.5590

Issue

Section

Research Articles

Similar Articles

<< < 

You may also start an advanced similarity search for this article.

Loading...