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The kidney is surrounded by tough fibrous tissue, the renal capsule, which is itself surrounded by perirenal fat, renal fascia, and pararenal fat. The anterior (front) surface of these tissues is the peritoneum, while the posterior (rear) surface is the transversalis fascia. The superior pole of the right kidney is adjacent to the liver.
From anterior to posterior, the renal vein exits, the renal artery enters, and the renal pelvis exits the kidney. On the left hand side the hilum is located at the L1 vertebral level and the right kidney at level L1-2. The lower border of the kidneys is usually alongside L3.
Despite the right kidney lying 1 cm lower than the left (right just below and the left just above the plane), [2] to be practical, the surface markings are taken the same way. The hilum of the kidney on the left and right is taken as 5 cm from the vertical midline and is on the transpyloric plane. [6]
[citation needed] A large "staghorn" kidney stone may block all or part of the renal pelvis. The size of the renal pelvis plays a major role in the grading of hydronephrosis . Normally, the anteroposterior diameter of the renal pelvis is less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [ 2 ]
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The arterial supply of the kidneys is variable and there may be one or more renal arteries supplying each kidney. [1] It is located above the renal vein. Supernumerary renal arteries (two or more arteries to a single kidney) are the most common renovascular anomaly, occurrence ranging from 25% to 40% of kidneys. [8]
The kidneys in mammals are usually bean-shaped [4] or externally lobulated. [5] They are located behind the peritoneum (retroperitoneally) [6] on the back wall of the body. [7] The typical mammalian kidney consists of a renal capsule, a peripheral cortex, an internal medulla, one or more renal calyces, and a renal pelvis. [7]
The venous drainage of the kidney large mirrors its arterial supply, except that there are no segmental veins. [4] The stellate veins arise from the capillaries, then drain successively through interlobular veins and interlobar veins until these converge from across the kidney to form the renal vein for that kidney.