A possible explanation for the frequent concomitance of arterial hypertension and multiple renal arteries

In more than 20% of subjects, at least one kidney is found to be supplied b y more than one artery arising from the aorta. This aberrant renovascular a natomy has been reported in the literature to occur in up to 80% of patient s who suffer from essential hypertension. Predominant numbers of the so-cal led 'accessory' vessels are longer and narrower than the segmental arteries arising in the main renal artery. As a result (in accordance with Poiseuil le's law of fluid flow), the renal segments supplied by these 'accessory' v essels may have lower levels of blood pressure than the remainder of the pa renchyma, thereby increasing the renin secretion. This hypothesis could be significant in terms of finding a causal treatment for a disorder induced b y such a mechanism. We first review the literature in which the frequency o f these vascular anomalies in normotensive and hypertensive patients is des cribed, and then advance a hypothesis explaining the frequent incidence of essential hypertension in these subjects, as well as the ramifications of t his phenomenon. (C) 2001 Harcourt Publishers Ltd.