Optimal Renal Artery-Aorta Angulation Revealed by Flow Simulation

Authors

David Csonka, Department of Mechanical Engineering, Faculty of Engineering and Information Technology, University of Pécs, Pécs, Hungary.
Károly Kalmár Nagy, Department of Surgery, Medical School, University of Pécs, Pécs, Hungary.
Péter Szakály, Department of Surgery, Medical School, University of Pécs, Pécs, Hungary.
Sándor Szukits, Department of Diagnostics, Medical School, University of Pécs, Pécs, Hungary.
Péter Bogner, Department of Diagnostics, Medical School, University of Pécs, Pécs, Hungary.
Akos Koller, Department of Morphology and Physiology, Faculty of Health Sciences, Budapest, Hungary.
Szilárd Kun, 2nd Department of Medicine and Nephrology-Diabetes Center, Medical School, University of Pécs, Pécs, Hungary.
István Wittmann, 2nd Department of Medicine and Nephrology-Diabetes Center, Medical School, University of Pécs, Pécs, Hungary.
István Ervin Háber, Department of Mechanical Engineering, Faculty of Engineering and Information Technology, University of Pécs, Pécs, Hungary.
Iván Gabor Horváth, Heart Institute, Medical School, University of Pécs, Pécs, Hungary.

Author Type(s)

Faculty

DOI

10.1159/000530169

Journal Title

Kidney & Blood Pressure Research

First Page

249

Last Page

259

Document Type

Article

Publication Date

1-1-2023

Department

Physiology

Abstract

INTRODUCTION: In the circulatory system, the vessel branching angle may have hemodynamic consequences. We hypothesized that there is a hemodynamically optimal range for the renal artery's branching angle. METHODS: Data on the posttransplant kinetics of estimated glomerular filtration rate (eGFR) were analyzed according to the donor and implant sides (right-to-right and left-to-right position; n = 46). The renal artery branching angle from the aorta of a randomly selected population was measured using an X-ray angiogram (n = 44). Computational fluid dynamics simulation was used to elucidate the hemodynamic effects of angulation. RESULTS AND DISCUSSION: Renal transplant patients receiving a right donor kidney to the right side showed faster adaptation and higher eGFR values than those receiving a left donor kidney to the right side (eGFR: 65 ± 7 vs. 56 ± 6 mL/min/1.73 m2; p < 0.01). The average branching angle on the left side was 78° and that on the right side was 66°. Simulation results showed that the pressure, volume flow, and velocity were relatively constant between 58° and 88°, indicating that this range is optimal for the kidneys. The turbulent kinetic energy does not change significantly between 58° and 78°. CONCLUSION: The results suggest that there is an optimal range for the renal artery's branching angle from the aorta where hemodynamic vulnerability caused by the degree of angulation is the lowest, which should be considered during kidney transplantations.

Recommended Citation

Csonka, D., Kalmár Nagy, K., Szakály, P., Szukits, S., Bogner, P., Koller, A., Kun, S., Wittmann, I., Háber, I. E., & Horváth, I. G. (2023). Optimal Renal Artery-Aorta Angulation Revealed by Flow Simulation. Kidney & Blood Pressure Research, 48 (1), 249-259. https://doi.org/10.1159/000530169