Distribution Of Peri-Arterial Renal Visceral Nerves

Objective: The Sympathetic Nerves supply to the kidneys is involved in the occurrence and development of several diseases including hypertension.At present,renal sympathetic denervation is a promising approach for the treatment of resistant hypertension,however,there are few report about anatomic distribution of peri-arterial renal nerves in the domestic research.The aim of our study is to investigate the distribution of nerves around human renal arteries.Methods: We collected 25 renal arteries from the patients who had a retroperitoneal laparoscopic nephrectomy and bilateral renal arteries from 7 human autopsy subjects.Each artery was equally divided into segments,which were made into paraffin sections.We examined the distribution of nerves around renal arteries and manually counted nerves by using optical microscope.In addition,we compared the difference of the distribution of nerves around the left renal arteries and the right renal arteries.Results: A total of 3065 nerve sections were identified from 258 slices.About 98% of all nerves existed within the renal arterial adventitia and the outside tissue.The mean number of nerves between the ventral,dorsal,superior,and inferior region of surgical specimens was 4.7±1.3,1.4±0.7,3.1±1.3,and 2.1±1.2,respectively.The mean number of nerves in the ventral region was greater compared with the dorsal region(P<0.01),the mean number of nerves in the superior region was also greater compared with the inferior region(P<0.05).The mean number of nerves in the middle segments was obviously greater compared with the distal segments(14.5±4.4 and 8.3±3.0,P<0.01).The mean number of nerves between the ventral,dorsal,superior,and inferior region of autopsy specimens was 5.4±1.4,1.5±0.7,3.1±0.8,and 2.8±1.0,respectively.The mean number of nerves in the ventral region was greater compared with the dorsal region(P<0.01),whereas the mean number of nerves was similar between the superior and inferior region(P=0.440).The mean number of nerves among the proximal,middle,and distal segments was 11.2±4.4,17.6±4.4,and 8.5±2.2.It was obvious that the mean number of nerves in the middle segments was greater compared with the proximal and diatal segments(P<0.01).The distribution of nerves around the left renal arteries was not considerably different compared with the right renal arteries.Conclusions: The distribution of peri-arterial renal visceral nerves is different in different regions.The mean number of nerves in the ventral region is greatest and least in the dorsal region.Along the renal artery,the distribution of nerves is relatively greater in the middle segments.Nerve distribution around the left renal arteries was not considerably different compared with the right renal arteries.