Severity of diverticulitis in patients with polycystic kidney disease without transplantation

Int J Colorectal Dis. 2017 Dec;32(12):1767-1770. doi: 10.1007/s00384-017-2911-8. Epub 2017 Sep 30.

Abstract

Background: Patients with polycystic kidney disease (PKD) who have had a kidney transplant have an increased risk of diverticular disease and complicated diverticulitis. Literature is limited regarding the severity of diverticulitis in patients with PKD who have not had a transplant. We aim to assess whether patients with PKD, with and without renal transplant, have a similar course of diverticulitis.

Methods: A retrospective review of all adult PKD patients at our institution diagnosed with diverticulitis between 2000 and 2016 was conducted. Patients without documented PKD and diverticulitis were excluded. We compared PKD patients with and without renal transplantation.

Results: A total of 41 patients were identified. Mean age was 60 (± 12), and 56% were female. Fourteen patients had undergone renal transplantation. Five (19%) non-transplant patients had complicated diverticulitis, compared to 43% (n = 6) transplanted (p = 0.33). Fifteen (56%) non-transplant and 8 (57%) transplant patients had recurrent diverticulitis (p = 1.00). Three (11%) non-transplant and 5 (36%) transplanted patients had recurrent complicated diverticulitis. Eight (30%) non-transplant and 7 (50%) transplant patients underwent surgery (p = 0.31). All 8 non-transplant patients underwent sigmoid resection with primary anastomosis without diversion. In the transplant group, 3 Hartmann procedures and 1 sigmoid resection with and 3 without diversion were performed. There was one in-hospital death in each group.

Conclusion: In our group of patients, there was no difference in rate of recurrent diverticulitis, diverticulitis complications, or operative intervention in patients with PKD with and without renal transplant. The renal transplant group had a higher rate of recurrent, complicated diverticulitis.

Keywords: Complicated diverticulitis; Diverticulitis; Polycystic kidney disease; Renal transplant.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Colectomy
  • Diverticulitis, Colonic / diagnosis
  • Diverticulitis, Colonic / etiology*
  • Diverticulitis, Colonic / mortality
  • Diverticulitis, Colonic / surgery
  • Female
  • Humans
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Minnesota
  • Polycystic Kidney Diseases / complications*
  • Polycystic Kidney Diseases / diagnosis
  • Polycystic Kidney Diseases / mortality
  • Polycystic Kidney Diseases / surgery
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome