Kidney Question

[Chandler]

Anyone know the left renal vein collateral circulation that is responsible for a decrease prevalence of a left kidney infarction (compared to the right) secondary to bilateral renal vein thrombosis?

 

[droliver]

Anyone know the left renal vein collateral circulation that is responsible for a decrease prevalence of a left kidney infarction (compared to the right) secondary to bilateral renal vein thrombosis?

The gonadal vein empties into the left renal vein on the left (the right one drains right into the nearby IVC) which provides a reverse shunt (I presume) out some of the accessory gonadal venous drainage that might let the kidney eek out a living in that scenario.

 

[Chandler]

The gonadal vein empties into the left renal vein on the left (the right one drains right into the nearby IVC) which provides a reverse shunt (I presume) out some of the accessory gonadal venous drainage that might let the kidney eek out a living in that scenario.

I was thinking the same thing and this would be the reason that we see varicoele on the left side for men, and dilated left ovarian vein for women. Still, I'm thinking there must be a 2nd drainage of the left renal vein. Around the region, there is a lumbar vein (L3 or L4 I think) that could drain into the azygos vein. Have you guys ever heard of a collateral between the left renal vein and a lumbar vein?

 

[priapoconstante]

I was thinking the same thing and this would be the reason that we see varicoele on the left side for men, and dilated left ovarian vein for women. Still, I'm thinking there must be a 2nd drainage of the left renal vein. Around the region, there is a lumbar vein (L3 or L4 I think) that could drain into the azygos vein. Have you guys ever heard of a collateral between the left renal vein and a lumbar vein?

Actually, yes, there are several veins that drain directly to the left renal vein: the left gonadal vein, the left suprarrenal vein, and one lumbar vein, wich, by the way, is interconected to other lumbar veins, and drain into the hemiazygos system.

 

[Chandler]

Actually, yes, there are several veins that drain directly to the left renal vein: the left gonadal vein, the left suprarrenal vein, and one lumbar vein, wich, by the way, is interconected to other lumbar veins, and drain into the hemiazygos system.

Bingo, this is why the left kidney has less cases of infarction secondary to bilateral renal vein thrombosis. The left renal vein has a collateral circulation into the HemiAzygos via the Lumbar vein! Thanks for the verification.