A new concept of zonal and segmental structure of the human kidney

To date, there is no single point of view on the lobar, zonal and segmental structure of the arterial tree of the kidney. There is no generally accepted approach in determining the signs by which the kidney is divided into lobes and/or segments. There is still a discussion regarding the division of the renal artery to daughter branches. The aim of the study was to establish variants of individual anatomical variability of the intra-organ arterial bed of the kidney, taking into account zonal and segmental topography. 116 corrosive preparations of the arterial system of the human kidney were studied. In 3D projections, the number of arterial vessels in the hilum of the kidney, topographic and anatomical features of the trunks of the renal arteries in the hilum of the kidney, variants of division of the renal arteries, zones of local blood supply to areas of the substance of the kidney, depending on the variants of division of the renal artery into branches of the 2nd and 3rd orders. The study was carried out using digital visualization methods, digital image processing and appropriate software. As a result, it was found that the renal artery can be divided into two (two-zonal system of blood supply to the kidney) and three (three-zone system of blood supply to the kidney) zonal arteries. In the case of a bizonal system, the renal artery divides into ventral and dorsal branches (54,2% of cases), as well as superior polar and inferior polar zonal branches (15,5% of cases). In the case of a three-zone system, the following options for the division of the renal artery have been established. The first option - on the upper polar, ventral and dorsal zonal branches (in 13,3% of cases); 2nd option - on the ventral, dorsal and lower polar zonal branches (in 9,4% of cases); 3rd variant - on two ventral and one dorsal zonal branches (in 5,1% of cases) and 4th variant on the superior pole, central and inferior pole zonal arteries (in 2,5% of cases). The results of the study convincingly indicate the need to revise the widespread idea of the five-segment structure of the human kidney.