Anatomical and Functional Alterations of the Gastrointestinal Tract in Polycystic Kidney Disease: A Multisystem Perspective

Polycystic kidney disease (PKD) is a multisystem disorder predominantly affecting the kidneys and liver. However, its impact on the gastrointestinal (GI) tract remains underrecognized. This study aimed to investigate the prevalence and characteristics of GI anatomical and functional alterations in patients with autosomal dominant polycystic kidney disease (ADPKD). A cross-sectional study was conducted at the Department of Anatomy, between January and March 2025. A total of 82 adult patients with confirmed ADPKD were enrolled. GI symptoms were assessed through structured interviews, validated questionnaires (GSRS, PAC-SYM), physical examinations, laboratory investigations, and radiological evaluations including abdominal ultrasound and MRI. Associations between clinical parameters and GI alterations were analyzed using appropriate statistical tests, with p-values <0.05 considered significant. The mean age of participants was 42.5 ± 12.3 years, with a slight male predominance (53.7%). The most common GI symptoms were abdominal bloating (63.4%), early satiety (57.3%), and constipation (53.7%). Radiological findings revealed bowel displacement (36.6%) and hepatomegaly-induced bowel compression (30.5%). Significant associations were found between GI alterations and total kidney volume (p<0.001), liver cyst burden (p=0.004), and reduced eGFR (p=0.032), while hypertension and diabetes mellitus showed no significant associations. Gastrointestinal complications are frequent in PKD and are significantly linked to disease burden and declining renal function. Early identification and management of GI involvement could enhance overall patient outcomes and quality of life.