Anatomical Variations in the Renal Hilum: Disposition of Vessels and Branching Patterns in Human Cadavers

Abstract

Background: The renal hilum is an important anatomical opening that leads to the kidney. It contains the renal artery, vein, and pelvis. The normal arrangement of the renal vein in front, the artery in the middle, and the pelvis in the back is not always the same. Congenital differences are common and important in medicine. These changes in anatomy affect urological, radiological, and surgical operations, such as nephrectomies and renal transplants. There are more and more kidney procedures happening in South Asia, but there is still not a lot of specific information about renal hilar variations, especially in the Bangladeshi population. Objective: The goal of this study was to look at the several ways that renal hilar structures can branch and change shape in adult Bangladeshi cadavers, see how common they are, and compare the results to data from across the world to help doctors make better decisions. Methodology: We did a descriptive cross-sectional study on 100 kidneys from unclaimed remains (50 right and 50 left). We put kidneys into four age groups: 10–19, 20–39, 40–59, and 60 years or older. We measured morphometric data including weight, length, breadth, and thickness, and then we used the ellipsoid formula to figure out the kidney volume. Histological study of cortical tissue from 5 pairs of kidneys found the size and density of the glomeruli. ANOVA, Student's t-test, Chi-square test, and Pearson correlation were all used to do the statistical analysis. Results: The most common anteroposterior hilar association was VAP (vein, artery, pelvis), which was found in 78% of kidneys. AVP was found in 21% of kidneys, while APV was found in 1%. The renal arteries had different numbers of branches: 72% had four, 19% had three, and 9% had two. The renal veins, on the other hand, always had one branch. Morphometric data showed that the group with the highest kidney volumes was the 20–39 years group (86.0 cm³). The volumes got smaller with age (≥60 years: 71.3 cm³). There were big differences in kidney volume between age groups (p=0.0012), but there were no differences between sides (p=0.19). There was a moderate negative connection between age and kidney volume (r = -0.46, p=0.0008). Conclusion: The renal hilar anatomy of people from Bangladesh is very different, especially when it comes to how the arteries branch and how the hilar structure relates to them. This shows how important it is to do routine preoperative vascular mapping. These results improve anatomical databases, which helps with planning surgeries and lowers the risk of problems during kidney procedures.