Renal vascularization variants vastly differ between individuals due to the very complex embryogenesis of the kidneys. Moreover, each variant may have implications for clinical and surgical interventions. The number of operating procedures continues to grow, and includes renal transplants, aneurysmorrhaphy and other vascular reconstructions. In any surgical technique, unawareness of the presence of multiple renal arteries may result in a fatal outcome, especially if laparoscopic methods are used. The aim of this review is to comprehensively identify the variation within multiple renal arteries and to highlight the connections between the presence of accessory renal arteries and the coexistence of other variants of vascularization. Another aim is to determine the potential clinical implications of the presence of accessory renal arteries. This study is of particular importance for surgeons, intervention radiologists, nephrologists and vascular surgeons.
The aim of this paper is to comprehensively analyze the literature focused on frequency of the presence of the accessory renal arteries in the human body. A systematic analysis of papers has been made. With regard to ethnicity, the incidence of accessory renal arteries fluctuates from 4% in a Malaysian population to 61.5% in a Brazilian population. The frequency is lowest in eastern and southern Asia (from 4% to 18.4%). In some, not ethnically homogenous populations, wide span of occurrence of accessory renal arteries is described (e.g. American - averaging from 18% to 28.8%). A higher frequency of accessory renal arteries was observed in fetuses compared to adults. Moreover, differences in the presence and number of accessory renal arteries reported in different papers are a consequence of type of visualizing technique used in research - especially when computed tomography and anatomical dissection were compared. The increasing number of surgical interventions, especially where laparoscopic methods are concerned, underlines the importance of such knowledge especially to surgeons, interventional radiologists, nephrologists, and vascular surgeons.
Organizm każdego człowieka składa się z tysięcy genów, miliardów neuronów i trylionów bakterii. Liczba danych łączących mikrobiotę jelit i prawidłowy rozwój oraz funkcjonowanie centralnego układu nerwowego stale wzrasta. Podnosi się także poziom wiedzy na temat związku pomiędzy florą bakteryjną jelit a zaburzeniami psychicznymi. Zjawisko to zostało nazwane ,,osią jelito-mózg". Dotychczas najsilniejsze dowody na rolę, jaką pełnią mikroby w osi jelito-mózg, pochodzą z badań na zwierzętach. Oś jelito-mózg jest systemem dwukierunkowej komunikacji, który nie tylko zapewnia homeostazę układu pokarmowego, lecz także może mieć wpływ na motywację oraz inne wyższe funkcje mózgu, w tym funkcje poznawcze. Flora bakteryjna jelit może mieć ponadto związek z otyłością oraz chorobami zapalnymi układu pokarmowego, w których ryzyko wystąpienia zaburzeń psychicznych wzrasta. Wyniki najnowszych badań wskazują na związek między składem mikrobioty jelitowej a zaburzeniami psychicznymi u zwierząt (reakcja na przewlekły stres, depresja). Temat ten wymaga dalszych badań, szczególnie ze względu na wiążące się z nim potencjalne opcje terapeutyczne.
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