Evaluation of colonic diverticular disease in autosomal dominant polycystic kidney disease without end-stage renal disease

A previous study had shown an increased prevalence (83%) of diverticula amo ng patients with autosomal dominant polycystic kidney disease (ADPKD) with end-stage renal disease (ESRD) compared with other ESRD patients without AD PKD (32%). Others have also suggested an increased risk for diverticular co mplications in renal transplant recipients with ADPKD. To determine whether there was an increased occurrence of diverticula among non-ESRD patients w ith ADPKD, we studied 55 patients with ADPKD who were not receiving renal r eplacement therapy compared with 12 unaffected family members (non-ADPKD) a nd 59 random patients who had undergone barium enemas (control [C]). No stu dy patient had a history of diverticular disease. All patients underwent a double-contrast barium enema after administration of glucagon. The occurren ce, number, location, and size of diverticula were noted. There was no sign ificant difference among the three groups in regard to sex (men: ADPKD, 42% versus non-ADPKD, 42% versus C, 37%) or age (ADPKD, 49.3 +/- 0.7 versus no n-ADPKD, 51.2 +/- 2.1 versus C, 49 +/- 1 years). There was no significant d ifference in the percentage of patients with diverticula (ADPKD, 47% versus non-ADPKD, 58% versus C, 59%), the percentage with only right-colon divert icula (ADPKD, 5% versus non-ADPKD, 17% versus C, 5%), the mean number of di verticula in patients with diverticulosis (ADPKD, 13.8 versus non-ADPKD, 7. 9 versus C, 9.9 diverticula), or the size of the largest diverticula (ADPKD , 9.5 versus non-ADPKD, 10.4 versus C, 10.5 mm). There was no significant d ifference in these variables between the patients with ADPKD with a creatin ine clearance greater than 70 mL/min/1.73 m(2) (n = 25) or less than 70 mL/ min/1.73 m(2), This study does not show the greater prevalence of diverticu lar disease in non-ESRD patients with ADPKD compared with the general popul ation. Thus, patients with ADPKD need not be considered at greater risk for diverticular disease than the general population. (C) 1999 by the National Kidney Foundation, Inc.