Correlation between Renal Artery Anatomy and Hypertension: A Retrospective Analysis of 3000 Patients

Abstract

Objective: To assess the correlation between renal artery anatomy and blood pressure in Undiagnosed Hypertension and Diagnosed Hypertension.

Methods: The renal artery CT scanning imaging data and laboratory data of 3000 inpatients and outpatients were collected retrospectively in 4 centers of China. Morphometric parameters were assessed using the quantitative vascular analysis (unit: mM).

Results: 687 cases (23.2%) had accessory renal arteries unilaterally, and 216 cases (7.3%) had bilateral accessory renal arteries, including left kidney 825 (27.9%) and right kidney 798 (27.0%). The presence of accessory renal arteries and renal artery branches was higher in the diagnosed hypertension group as compared with the undiagnosed hypertension group (MARB, pp < 0.001; ARA, p < 0.001; others, p < 0.001). Consequently, multivariate regression analysis showed that age (OR = 2.519 (95% CI: 0.990-6.411, p < 0.001)), dyslipidemia (OR = 1.187 (95% CI: 0.960-1.454, p = 0.007)), renal hilum Outside the main renal artery branch (MRAB) (OR = 2.069 (95% CI: 1.614-2.524, p = 0.002)), and accessory renal artery (ARA) (OR = 2.071 (95% CI: 1.614-2.634, p = 0.001)) were risk factors of hypertension. In addition, higher renin activity was associated with ARA patients (2.19 ± 2.91 vs. 1.75 ± 2.85, p < 0.001).

Conclusions: When comparing renal arteries side by side, the anatomical length of the renal arteries is significantly different. In addition, the prevalence of accessory renal arteries and renal artery branches is higher in the hypertension group. The auxiliary renal artery and the main renal artery branch outside the renal portal are independent factors of hypertension. Renal sympathetic nerve activity is affected by renin activity and is related to the accessory renal artery.

Figure 1

Naming rules of renal artery. Main renal artery branches outside the renal hilum (MRAB), main renal artery branches in the renal hilum (MRA) and the accessory renal artery branch of the abdominal aorta (ARA).

Figure 2

Types of renal artery and accessory renal artery described in enhanced renal CT scan. Different accessory renal arteries with renal CT scan. (a) No accessory renal artery (NAR); (b) main renal artery branches outside the renal hilum (MRAB); (c) the accessory renal artery (ARA).

Figure 3

Renin activity with different types of renal artery and accessory renal artery. Quantitative analysis of renin activity in different subgroups. No accessory renal artery (NAR); main renal artery branches outside the renal hilum (MRAB), the accessory renal artery (ARA).

Figure 4

Renin activity of different renal artery mean diameter. Changes of renin activity according to the diameters of left (a) and right (b) renal artery and according to renal artery mean diameter. p values are ANOVA for trends.