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

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.