Incidence, Risk Factors, Clinical Presentation, and Treatment Outcomes of Acute Diverticulitis Requiring Hospitalization in Kidney Transplant Recipients.

Abstract

Acute diverticulitis, a complication of diverticulosis, poses significant challenges in kidney transplant recipients who are often on immunosuppressive therapy. This retrospective single-center observational cohort study analyzes the incidence, clinical presentation, and management of acute diverticulitis in kidney transplant patients at University Hospital Center Zagreb over a 14-year period. Among 1400 kidney transplant recipients, 10 patients (0.7%) developed acute diverticulitis requiring hospitalization. The average age of these patients was 60.7 years, with abdominal pain as the predominant symptom. Diagnostic imaging confirmed diverticulitis in all cases, predominantly affecting the sigmoid colon. Treatment involved intravenous antibiotics, with surgical interventions required in 4 cases due to complications, including abscess formation and perforation. The duration of hospitalization averaged 7.75 days, with a 10% mortality rate observed in this cohort. Recurrences of diverticulitis were noted, necessitating further hospitalizations in 4 patients. Notably, there were no cases of acute graft rejection within 1 year pre-diverticulitis. This study highlights the need for tailored management strategies for kidney transplant recipients with diverticulitis, as their unique clinical profiles warrant careful consideration of immunosuppressive therapy and potential complications. Further research is needed to establish comprehensive guidelines for managing diverticulitis in this vulnerable population.