Advanced CKD Consistently Linked to Higher Risk of Gastroparesis: Study
USA: Analysis of two large, independent inpatient and outpatient datasets shows a consistent association between increasing CKD severity and gastroparesis.
These findings emphasize the need for routine screening and early management of gastroparesis in patients with advanced CKD, particularly those presenting with early satiety or dyspepsia, to improve outcomes and reduce disease burden.
Chronic kidney disease (CKD) is frequently accompanied by upper gastrointestinal symptoms such as nausea, vomiting, epigastric discomfort, and early satiety. These complaints are often attributed to electrolyte disturbances, uremia, or fluid overload. However, emerging evidence suggests that delayed gastric emptying, or gastroparesis, may play a larger role than previously recognized.
Gastroparesis can worsen nutritional status, promote intermittent dehydration, and potentially accelerate the decline of residual kidney function, yet it remains underdiagnosed in this population.
In a study published in the Journal of Personalized Medicine, Xiaoliang Wang from the Digestive Disease & Surgery Institute at the Cleveland Clinic and colleagues explored the relationship between CKD severity and gastroparesis using a dual, population-based retrospective approach. By leveraging both inpatient and outpatient datasets, the investigators aimed to provide a comprehensive and generalizable assessment of this association across different clinical settings.
The inpatient analysis drew on data from the National Inpatient Sample (NIS), identifying more than 3.5 million patients diagnosed with gastroparesis, with and without coexisting CKD. In parallel, the outpatient component utilized the TriNetX database, which included over 6.2 million patients presenting to ambulatory clinics with nausea and vomiting as a chief complaint. In both datasets, gastroparesis was identified using standardized ICD-10-CM diagnostic codes.
The study led to the following notable findings:
- In the inpatient cohort, gastroparesis prevalence increased progressively with worsening CKD stage, with the highest risk observed in patients with advanced CKD compared with those without kidney disease.
- This severity-dependent pattern suggested a close link between declining renal function and impaired gastric motility.
- In the outpatient cohort, patients with CKD also showed a higher risk of gastroparesis, although stage-specific differences were less consistent before adjustment.
- After rigorous propensity score matching, advanced CKD remained significantly associated with increased odds of gastroparesis.
- The strongest association was observed in patients with end-stage renal disease, supporting and reinforcing the inpatient findings.
According to the authors, the consistency of results across two large and independent datasets strengthens the evidence that gastroparesis represents an underrecognized comorbidity in CKD. Delayed gastric emptying in advanced CKD may further compromise nutrition, exacerbate gastrointestinal symptoms, and adversely affect overall prognosis, particularly in patients already vulnerable to metabolic and volume-related complications.
The study highlights the clinical importance of actively evaluating CKD patients who report early satiety, dyspepsia, or persistent nausea for possible gastroparesis. Early identification and targeted management could improve quality of life, reduce complications, and lessen healthcare utilization.
The authors emphasize that integrating routine screening for gastroparesis into CKD care pathways may support a more personalized and proactive approach to managing this complex patient population.
Reference:
Wang, X., Almetwali, O., Tan, D., Wang, J., & Song, G. (2025). The Hidden Burden of Gastroparesis in Chronic Kidney Disease: Evidence from Inpatient and Outpatient Cohorts for Personalized Care. Journal of Personalized Medicine, 15(12), 600. https://doi.org/10.3390/jpm15120600
Next Story