Delayed Gastric Emptying Is Associated With Progression to End-Stage Renal Disease in Diabetic Patients With Chronic Upper Gastrointestinal Symptoms

Background/Aims: This study aimed to investigate whether delayed gastric emptying (GE) is associated with progression to end-stage renal disease (ESRD) in diabetic patients with chronic upper gastrointestinal (UGI) symptoms.Methods: We extracted data on demographics, UGI symptoms, GE study, and renal outcome from the medical records of diabetic patients with chronic UGI symptoms who underwent a GE study over 17 years.Renal outcome was defined as the development of ESRD.An association between delayed GE and renal outcome was investigated using a Cox proportional hazards regression model with Firth's correction.Results: Among 515 subjects who had undergone a GE study, 100 patients with type 1 or type 2 diabetes (67 females, 85 with type 2 diabetes, median age 63 years) were included.Of the 100 patients, 53 had delayed GE.During the follow-up (median, 264 weeks), 25 patients with diabetes developed ESRD.The Firth-penalized Cox regression model showed that delayed GE was significantly associated with renal outcome in diabetic patients with chronic UGI symptoms (hazard ratio 3.12; 95% confidence interval 1.34-7.97;P = 0.008).The 5-year cumulative incidence of renal outcome was approximately 9% in patients with normal GE and 35% in those with delayed GE (log-rank P = 0.021).Conclusions: Delayed GE was associated with progression to ESRD in diabetic patients with chronic UGI symptoms.