To determine whether the renal arterial system has a fractal structure
. the fractal dimension of renal angiograms from 52 necropsy cases was
measured using an implementation of the box-counting method on an ima
ge analysis system. The method was validated using objects with known
fractal dimensions. The method was accurate with errors of less than 1
.5 per cent and reproducible with initial values within 1.2 per cent o
f the mean of ten sets of measurements (reliability coefficient 0.968,
95 per cent confidence limits 0.911-0.984). In the 36 satisfactory an
giograms the mean fractal dimension was 1.61 (SD 0.06), which was sign
ificantly greater than the topological dimension of 1 (P<0.0001), indi
cating that the renal arterial tree has a fractal structure. There was
no significant relationship between age (P=0.494), sex (P=0.136), or
systolic (P=0.069) or diastolic (P=0.990) blood pressure, but two cong
enitally abnormal kidneys (hypoplastic dysplasia and renal artery sten
osis) had fractal dimensions at the lower end of the normal range (thi
rd percentile). Since the renal arterial tree has a fractal structure,
Euclidean geometric measurements, such as area and boundary length, a
re invalid outside precisely defined conditions of magnification and r
esolution.