Expansion
Vein, Artery, Ureter from front to back
Expansion
At the hilum, from anterior to posterior:
- V - Renal vein
- A - Renal artery
- U - Ureter (renal pelvis)
The left renal vein is about three times longer than the right, because the inferior vena cava lies on the right of the midline. It crosses the aorta anteriorly, passing between the aorta and the superior mesenteric artery.
That course has two consequences. Compression there produces nutcracker syndrome, with left flank pain and haematuria. And because the left renal vein also receives the left gonadal vein, its compression contributes to the predominance of left-sided varicocele.
The longer left renal vein is also why the left kidney is preferred for live donor nephrectomy.