Lauder L, Ewen S, Tzafriri AR, Edelman ER, Lüscher TF, Blankenstijn PJ, Dörr O, Schlaich M, Sharif F, Voskuil M, Zeller T, Ukena C, Scheller B, Böhm M, Mahfoud F; Renal artery anatomy in hypertensive patients study collaborators. Renal artery anatomy assessed by quantitative analysis of selective renal artery in 1000 patients with hypertension.
Summary: With increasing attention to renovascular causes and targets for hypertension arises a critical need for more detailed knowledge of renal arterial anatomy. However, a standardized nomenclature is lacking. 1000 hypertensive patients underwent invasive selective renal artery angiography in 9 centers. Further, renovasography was performed in 249 healthy swine as a surrogate for normotensive anatomy. Anatomical parameters were assessed by quantitative vascular analysis. Patients’ mean blood pressure was 168/90 ± 26/17 mmHg. Accessory renal arteries and renal artery disease were documented in 22% and 9% of the patients, respectively. Other than exhibiting a longer left main renal artery in uncontrolled hypertensives, there was no anatomical difference between patients with controlled and uncontrolled hypertension. Main renal artery mean diameter was smaller in patients with impaired kidney function.
Renal arterial anatomy differs between sides but shows no difference between patients with and without blood pressure control. Impaired GFR was associated with small main renal artery diameter.