Gerota’s Fascia

What is Gerota’s fascia?

Gerota’s fascia is a sheath of connective tissue that surrounds your kidneys and adrenal glands.

Gerota’s fascia contains your kidneys, your adrenal glands and the natural fat around your kidneys, also known as perinephric fat.

What does Gerota’s fascia do?

Gerota’s fascia encloses your kidneys and adrenal glands. It separates your kidneys from your body’s other organs so your kidneys can work properly.

What do your kidneys and adrenal glands do?

Your kidneys filter your blood. They also remove waste from your body and excess water from your blood. Your body removes these products as pee (urine). Your kidneys also:

• Maintain your body’s fluid levels.
• Regulate chemicals and minerals.
• Help to regulate your blood pressure.
• Clear excess fluids from your body.

Your adrenal glands are separate structures that make hormones that contribute to the regulation of your:

• Blood pressure.
• Immune system.
• Metabolism.
• Response to stress.

Where is Gerota’s fascia located?

Gerota’s fascia surrounds your kidneys and adrenal glands. It separates these structures from your:

• Abdominal aorta, which runs from your diaphragm to your pelvis.
• Inferior vena cava, the large vein that brings blood from your belly (abdomen) and legs to your heart.
• Renal arteries and veins.

What is the structure of Gerota’s fascia?

Connective tissue (collagen) makes up Gerota’s fascia. This connective tissue is very thin but still rather strong.

Gerota’s fascia fuses on three sides of your kidneys:

• Anterior: Gerota’s fascia in front of one kidney fuses with Gerota’s fascia in front of your other kidney.
• Posterior: At the back of your kidneys, Gerota’s fascia fuses with a muscle between your vertebral column and your pelvis (psoas fascia).
• Superior: Gerota’s fascia and posterior renal fascia join at the upper part of your kidneys. They then split to surround your adrenal glands.

What conditions affect Gerota’s fascia?

Conditions that may affect your Gerota’s fascia include:

• Adrenal tumors: Growths on your adrenal glands.
• Kidney cancer: Classified as stage 1 to 3 or T3 if confined within Gerota’s fascia. Stage 4 means invasion of Gerota’s fascia.
• Kidney stones: Invasive solid masses in your kidneys.
• Perinephric abscesses: Pockets of pus that develop within Gerota’s fascia. This may be due to diabetes, pregnancy, abnormalities in your urinary tract, a urinary tract infection (UTI) or a kidney infection.

What are common tests to check the health of Gerota’s fascia?

Common tests to check the health or status of Gerota’s fascia include:

• Kidney ultrasound.
• Computed tomography (CT) scan with contrast.
• Magnetic resonance imaging (MRI) scan.

How does Gerota’s fascia help diagnose other conditions?

Healthcare providers evaluate Gerota’s fascia to help diagnose or stage other conditions that may affect your kidneys. These include:

• Kidney cancer: Providers evaluate Gerota’s fascia during the process of staging kidney cancer. This helps them choose the best treatment options.
• Masses in your kidneys: CT scans and ultrasounds show Gerota’s fascia and whether there's a kidney mass that may be invading the fascia.

What are simple lifestyle changes to keep Gerota’s fascia healthy?

You can reduce your risk of developing a problem with your Gerota’s fascia by:

• Drinking plenty of water.
• Exercising regularly.
• Keeping steady blood sugar (glucose) levels if you have diabetes.
• Limiting use of non-steroidal anti-inflammatory drugs, which can lead to kidney damage.
• Maintaining a healthy weight.
• Not smoking, or quitting smoking if you do smoke.
• Reducing your salt intake.
• Visiting your healthcare provider for annual checkups.

A note from Cleveland Clinic

Gerota’s fascia is a connective tissue (collagen) sheath surrounding your kidneys and adrenal glands. Gerota’s fascia works together with posterior renal fascia (Zuckerkandl’s fascia) to enclose your kidneys. These connective tissues separate your kidneys from other organs. This helps your kidneys filter blood and remove waste. Kidney cancer and perinephric abscesses can affect Gerota’s fascia. Providers also run tests such as CT scans and ultrasounds to evaluate Gerota’s fascia to help diagnose tumors and kidney stones. Simple lifestyle changes can help keep your Gerota’s fascia and kidneys healthy.