The effect of the presence of accessory renal arteries on biochemical parameters of renal function and blood pressure regulation

Objective: The effect of having accessory renal arteries on hemodynamics and renal function has been studied in different populations, yielding variable results – from a significant correlation between the presence of accessory renal arteries and increased arterial blood pressure and/or serum creatinine and renin to no correlation whatsoever. The aim of this study was to evaluate the effects of the presence of accessory renal arteries on biochemical parameters related to renal function and hemodynamics in a Croatian population. Design and method: This was a retrospective single-center study. Data was collected from the hospital informatics system on patients with accessory renal arteries managed in the arterial hypertension clinic of a tertiary care center. Patient data obtained between 2012 and 2023 was included. In order to be included into the study, patients needed to have available data on laboratory parameters, hemodynamics and an image of a multi-slice computed tomography intravenous contrast-enhanced scan of the aorta and renal arteries. Patients without all of the aforementioned data were excluded from the study. Data was analyzed using the JASP open-source statistical software. Statistical significance was set at a threshold of p < 0.05. Results: 155 patients in total were included in the study – 80 without accessory renal arteries and 75 with one or more accessory renal arteries. The distribution of age and gender was equivalent between the two groups. The group with accessory renal arteries had significantly higher mean arterial pressures (100 mmHg vs 95.7 mmHg, p = 0.016), lower estimated glomerular filtration rates calculated by CKD-EPI 2021 formulas (80 mL/min/1.73m2 vs 96 mL/min/1.73m2, p < 0.001) and had a significantly higher number of antihypertensive medications in their therapy (3 vs 1.5 different types of medications, p < 0.001). There were no significant differences between other measured parameters (serum electrolytes, renin, aldosterone, aldosterone/renin ratio). Conclusions: The results of this study indicate that the presence of accessory renal arteries might have an effect on the success of antihypertensive therapy and that these patients may represent a distinct phenotypic group that requires a personalized approach.