Aorticorenal Plexus - Structure, Location, Function

The aorticorenal plexus is a network of autonomic nerve fibers that surrounds the origin of the renal arteries and lies near the junction of the celiac plexus and superior mesenteric plexus. It provides sympathetic and parasympathetic innervation to the kidneys, suprarenal (adrenal) glands, proximal ureters, and adjacent structures. It plays a key role in regulating renal blood flow, urine formation, and adrenal medullary hormone release.

Structure

This plexus is formed by contributions from:

Lesser splanchnic nerves (T10–T11): Primary sympathetic input
Least splanchnic nerves (T12): Additional sympathetic fibers
Celiac plexus and aortic plexus: Continuity with adjacent prevertebral plexuses
Vagus nerve (CN X): Occasional parasympathetic contribution

The plexus contains the aorticorenal ganglia, small clusters of sympathetic neuron cell bodies located near the origin of each renal artery.

Key Components and Targets:

Branch	Target Organ	Function
Renal nerve plexus	Kidneys	Regulates renal blood flow and filtration rate
Suprarenal plexus	Adrenal medulla	Triggers catecholamine release (epinephrine, norepinephrine)
Ureteric branches	Proximal ureter	Controls ureteric smooth muscle contraction

Location

The aorticorenal plexus is located:

Anterior to the aorta, surrounding the origins of the left and right renal arteries
Inferior to the celiac trunk and adjacent to the superior mesenteric artery
Medial to the adrenal glands and renal hila

Function

This plexus regulates visceral autonomic functions in the retroperitoneal region:

Sympathetic input: Reduces renal blood flow and glomerular filtration; stimulates adrenal medulla to release catecholamines
Parasympathetic input: Minimal but may influence ureteric peristalsis and renal pelvic relaxation
Visceral sensory fibers: Transmit pain and pressure sensations from kidneys and ureters to spinal levels T10–L2

Clinical Significance

Renal colic (ureteric stones): Visceral pain follows sympathetic afferents from this plexus and often refers to the flank or groin
Hypertension management: Renal denervation procedures may target the renal nerves that arise from this plexus
Adrenal tumors: Pheochromocytomas can affect autonomic feedback from the suprarenal branches of this plexus
Sympathetic blocks: Interventions near the aorticorenal plexus may help manage severe renal or adrenal pain syndromes

The aorticorenal plexus serves as a critical autonomic relay for renal and adrenal function. Its close anatomical relationship with major abdominal arteries and retroperitoneal structures makes it both clinically important and vulnerable during surgical and interventional procedures.