Gerota’s Fascia

Gerota’s fascia (pronounced “gay-ROH-tuhz” “FASH-ee-uh”) is a layer of tough connective tissue. It surrounds:

• Adrenal glands, which are on top of your kidneys
• Kidneys
• The fat around your kidneys (perinephric fat)

Other names for Gerota’s fascia include:

• Renal (kidney) fascia
• Gerota’s capsule

What does Gerota’s fascia do?

Gerota’s fascia covers your kidneys and adrenal glands. It:

• Separates your adrenal glands and kidneys from the other organs in your abdominal cavity
• Surrounds these organs to support them and keep them in place, which allows your kidneys and adrenal glands to function properly
• Protects your kidneys from trauma
• Helps prevent the spread of infection or bleeding

Where is Gerota’s fascia located?

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

• Abdominal aorta: Your abdominal aorta runs from your diaphragm to your pelvis. It’s the main artery that carries oxygen-rich blood to organs in your abdomen and the lower half of your body.
• Inferior vena cava: Your inferior vena cava is a large vein. It brings oxygen-depleted blood from your abdomen and legs to your heart.
• Renal arteries and veins: Renal arteries carry blood from your heart to your kidneys. Renal veins carry blood from your kidneys to your heart.

What is the structure?

A fibrous connective tissue that contains collagen makes up Gerota’s fascia. Think of it like a hot dog casing. The tissue is thin. But it’s strong.

Gerota’s fascia comes together on three sides of your kidneys:

• Anterior: Gerota’s fascia in front of one kidney fuses with the fascia in front of your other kidney.
• Posterior: At the back of your kidneys, the renal fascia attaches to the muscles at the back of the abdominal cavity.
• Superior: Gerota’s fascia and the posterior renal fascia join at the upper part of your kidneys. They then split to surround your adrenal glands.

What does it look like?

In most people, Gerota’s fascia has a structure like a sandwich. The central layer consists of long, thick collagen fibers. The edges consist of small collagen fibers. But in some people, Gerota’s fascia only consists of small collagen fibers. On average, it’s a little over 460 micrometers thick — about a quarter as wide as a strand of spaghetti.

What conditions affect Gerota’s fascia?

• Adrenal tumors
• Kidney cancer
• Kidney stones
• Pockets of pus (perinephric abscesses)

How does Gerota’s fascia help diagnose other conditions?

Gerota’s fascia can be very helpful in diagnosing kidney conditions and staging kidney cancers. Early stages of kidney cancer don’t affect Gerota’s fascia. But in stage 4 kidney cancer, the tumor extends into the Gerota’s fascia. It may also affect the adrenal gland. Stage 4 cancer usually requires more intensive treatment, including surgery and chemotherapy.

Healthcare providers may also use CT scans and ultrasounds to get detailed looks at your Gerota’s fascia. These imaging tests can show kidney masses or stones that may be affecting your fascia. They can also show bleeding in or around your kidney or if there’s an infection.

How can you keep Gerota’s fascia healthy?

Keeping your kidneys healthy helps keep your Gerota’s fascia healthy. You can promote kidney health by:

• Avoiding or quitting tobacco products
• Drinking plenty of water
• Getting regular physical activity
• Keeping steady blood sugar (glucose) levels if you have diabetes
• Limiting the use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• Lowering your salt intake
• Maintaining a healthy weight for you
• Visiting a healthcare provider for annual check-ups

What is the difference between Gerota’s fascia and the renal capsule?

Gerota’s fascia covers your kidney, adrenal gland and surrounding perinephric fat. The renal capsule is a different layer of tough, fibrous tissue that directly encases your kidneys. It also helps protect your kidneys and keep them in place. Gerota’s fascia covers the renal capsule.