Prevalence of Accessory Renal Arteries in Africa: A Systematic Review and Meta‐Analysis Using Anatomical Quality Assurance (AQUA) Checklist

ABSTRACT Background and Aims Variations of accessory renal arteries are different in different population groups, but comprehensive reviews for the ethnically diverse continent of Africa are lacking. Therefore, this review aimed to describe the prevalence of accessory renal arteries in the African population based on specimens from cadaveric, CT angiography, and kidney transplant intraoperative reviews. Methods By searching PubMed, Google Scholar, Hinari, and websites (Google, Yahoo), the renal arterial vasculature of 2451 study subjects and 4882 kidneys were retrieved from 17 studies. Anatomical variations of accessory renal arteries were categorized based on prevalence, sex, symmetry, laterality, and termination in the superior pole, hilum, and inferior pole of the kidneys. Results Accessory renal arteries were found in 19.7% of study subjects, with 70% of these being males. Additionally, 13.9% of kidneys had accessory renal arteries, with 77.9% of these variations being unilateral. The most common pattern discovered was the presence of single accessory arteries (80.2%). The inferior pole was the predominant point of entry (42%), followed by hilar arteries (39%). Furthermore, a significant difference was observed between the prevalence of left‐ and right‐sided accessory arteries, with a dominance of left‐sided arteries (57.1%). Conclusion Accessory renal arteries exhibit high prevalence, particularly among males, with the inferior pole as the primary entry point and left‐sided dominance. However, the significant heterogeneity and the lack of data from most countries necessitate cautious interpretation. In light of these variations, these findings point out the importance of these reviewed articles as essential references for renal transplantation and other urological procedures.