The renal pyramids are the striped, cone-shaped masses that make up the renal medulla. Each kidney has about 8 to 18, with their broad bases facing the cortex and their tips (papillae) pointing into the minor calyces. The stripes come from the parallel loops of Henle and collecting ducts running through them.
| Location | In the renal medulla, separated from each other by the renal columns, with bases toward the cortex and apices toward the renal sinus |
|---|---|
| Parts |
|
| Nerve Supply | Renal plexus |
| Blood Supply | Arcuate arteries; Vasa recta |
| Venous drainage |
|
| Lymphatic drainage |
|
Concentrate urine and channel it from the collecting ducts toward the papillae and minor calyces.
On ultrasound, pyramids appear darker than the cortex, which helps radiologists judge kidney structure. Calcium deposits within the pyramids (medullary nephrocalcinosis) occur with high calcium levels, renal tubular acidosis and medullary sponge kidney. Ischaemic damage can cause the tips to die and slough off, blocking the urinary tract.
Calcium deposits in the pyramids, often linked with high blood calcium, high urine calcium or renal tubular acidosis, and associated with stone formation.
Death of the pyramid tips from poor blood supply, seen with diabetes, sickle cell disease, analgesic overuse and severe infection.
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