Global Prevalence of Accessory Renal Arteries: A Systematic Review and Meta-Analysis of Cadaveric and Imaging Studies

Background: Accessory renal arteries (ARAs) are one of the most frequent anatomical variations of the renal vasculature and play a crucial role in both surgical and radiological practice. But there is a wide report of prevalence across studies and populations. The aim of the research is to establish the worldwide occurrence of accessory renal arteries by carrying out systematic review and meta-analysis of cadaveric and imaging-based studies. Methods: In search of studies that reported the prevalence of accessory renal arteries, a thorough literature search was performed using PubMed, Scopus and Web of Science. Eligible articles were cadaveric and radiological studies that had extractable data. The selection of the studies was based on PRISMA 2020 guidelines. The extraction of data involved author details, study design, sample size, population and prevalence of accessory renal arteries. The AQUA tool was used to perform quality assessment. Random-effects model was used to give the pooled prevalence and the heterogeneity was estimated by using I2 statistic. Funnel plot and Egger test were used to determine publication bias. Results: 24 studies involving 15,230 kidneys were used. Accessory renal arteries had a prevalence of 28.6% (95% CI: 25.1%-32.2%) which was highly heterogeneous (I2 = 89.2%). Subgroup analysis showed a little bit greater prevalence of imaging based studies when compared with cadaveric studies. It was also found to vary regionally with higher prevalence being reported in Asian populations. Symmetry of funnel plot and test of Egger showed that there was not a high risk of publication bias. Conclusion: Accessory renal arteries are present in nearly one-third of individual worldwide. These variations can be identified in preoperative phase and this step is essential to surgical planning and enhancement of clinical outcome. The paper gives a detailed international estimation and supports the significance of anatomical awareness in the clinical practice.