CorpusHuman Anatomy
UrinaryRegion

Renal hilum and renal sinus

Hilum renale; sinus renalis

Also known as: hilus of kidney, renal sinus

The vertical slit on the medial border of the kidney through which the renal vein, renal artery and renal pelvis pass (anterior → posterior), opening into the fat-filled renal sinus.

Show on body map Kidney — Coronal Section

Overview

The hilum is the entrance to the renal sinus, a central space occupied by the renal pelvis, major and minor calyces, branches of the renal artery and tributaries of the renal vein, nerves, lymphatics and fat. From anterior to posterior the hilar structures are the renal vein, renal artery and renal pelvis (VAP); a posterior segmental branch of the artery often passes behind the pelvis. Lymph vessels and nerves of the renal plexus accompany the vessels.

The left hilum lies a little above, and the right a little below, the transpyloric plane (L1), about 5 cm from the midline. Within the sinus the renal papillae project into the minor calyces.

Location

Concave medial border of each kidney, at about L1.

Parts & subdivisions

  1. Renal vein
    Most anterior hilar structure; the left one crosses anterior to the aorta.
  2. Renal artery
    Intermediate; divides into anterior and posterior divisions and then segmental arteries in the sinus.
  3. Renal pelvis
    Most posterior; narrows into the ureter at the ureteropelvic junction.
  4. Sinus fat
    Continuous with perirenal fat; separates the collecting system from the vessels.

Function

  • Transmit the vessels, nerves, lymphatics and urinary outflow of the kidney

Clinical significance

Surgical access to the hilum

At nephrectomy the renal artery is ligated before the vein to avoid engorgement. The left kidney is preferred for living donation because its renal vein is longer.

Mnemonics

VAP

Vein — Artery — Pelvis, anterior to posterior.

Compiled from standard anatomy and physiology references — see the Urinary System sources. For education only; not medical advice.