About

Nikki Duong is a Clinical Assistant Professor of Medicine in the Division of Gastroenterology & Hepatology at Stanford University. He is a general and transplant hepatologist, board-certified in gastroenterology, with a specialization in caring for patients with chronic liver disease, viral hepatitis, fatty liver, autoimmune disorders, hepatocellular cancer, and cirrhosis. Raised by immigrant parents, he understands the complexities surrounding access to care and social determinants of health, and he strives to provide outstanding evidence-based care to every patient. Dr. Duong emphasizes the principle of 'cura personalis,' focusing on understanding the bigger picture, thinking outside of the box, and integrating science, technology, integrity, and humanism in medical care. He has dedicated his early career to being a beacon for LGBTQIA+ providers and patients, serving as a founding member and current executive board member of Rainbows in Gastro, a national affinity group for research, mentorship, and community advocacy. His interests include patient-reported outcomes in cirrhosis, general gastroenterology, hepatology, LGBTQIA+ health, and medical education. Dr. Duong has been recognized with numerous awards for his research, mentorship, and teaching, and he actively participates in professional organizations, including the American College of Gastroenterology and the American Association for the Study of Liver Diseases.

Research topics

• Internal medicine
• Medicine
• Intensive care medicine
• Gerontology

Selected publications

• Step by Step: A Meta-Analysis and Systematic Review on the Impact of Walking on Colonoscopy Outcomes

  Digestive Diseases · 2025-05-08

  reviewOpen access

  INTRODUCTION: Colorectal cancer screening relies on effective bowel preparation before a colonoscopy. Walking has emerged as a potential adjunct strategy to achieve bowel cleansing prior to colonoscopy. We investigated the efficacy of walking as a potential adjunct strategy to bowel preparation methods. METHODS: Our search encompassed Embase, Medline, Cochrane, and Scopus databases. Search results underwent screening utilizing Covidence based on predefined criteria. Data extraction performed by independent reviewers involved general characteristics, baseline patient characteristics, and outcome measures. Risk of bias evaluation employed the RoB 2 tool for randomized controlled trials (RCTs). Statistical analysis utilized RevMan v5.3, employing mean differences and random-effects models. Statistical significance was indicated by p value <0.05. Heterogeneity was assessed with I2 tests. RESULTS: Our meta-analysis included four RCTs with a total of 1,218 patients. We found that walking did not yield a significant difference in total BBPS score compared to control groups. Walking led to statistically significant improvements in ascending, transverse, and descending colon BBPS scores. Walking did not significantly affect cecal intubation time or total procedure time. While there was no significant difference in the time to first diarrhea, the total number of diarrheal episodes was significantly impacted. CONCLUSION: While walking did not significantly affect total BBPS scores, procedural timelines, or cecal intubation, it demonstrated significant improvements in ascending, transverse, and descending colon BBPS scores and diarrheal instances. These findings suggest that walking may have a beneficial effect on specific aspects of bowel preparation for colonoscopy, highlighting its potential as an adjunctive strategy in enhancing colonoscopy outcomes.

  PublisherOA PDFDOI

• Redefining fatty liver as metabolic dysfunction-associated steatotic liver disease: Implications of nomenclature changes for patients with diabetes

  World Journal of Hepatology · 2025-11-27 · 1 citations

  reviewOpen accessSenior author

  The evolving nomenclature from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) aims to better encompass the metabolic context of the disease. This change has significant implications for patients with type 2 diabetes mellitus (T2DM), given the frequent overlap between these conditions. This minireview explores the rationale behind the change, compares diagnostic criteria, and evaluates the impact of the MASLD framework on disease prevalence, characterization, and outcomes in T2DM patients. The updated MASLD criteria include all individuals with T2DM and hepatic steatosis, emphasizing metabolic dysfunction as the primary driver. In contrast, the NAFLD definition necessitates excluding other chronic liver diseases and verifying the absence of significant alcohol consumption, leading to a narrower diagnostic framework. Both metabolic dysfunction-associated fatty liver disease and MASLD identify a higher prevalence of steatotic liver disease, particularly among T2DM patients, compared to NAFLD. Notably, the MASLD framework introduces metabolic and alcohol-associated liver disease to account for dual etiologies involving alcohol use, which is common in T2DM populations but previously excluded under NAFLD criteria. While the new definitions enhance clinical relevance and inclusivity, they also highlight challenges such as unrecognized medication-induced steatosis and the need for reclassification in ongoing T2DM clinical trials. Emerging evidence supports enhanced screening strategies (e.g. , fibrosis-4) and metabolic-targeted treatments for MASLD in T2DM patients. The successful integration of MASLD into clinical practice will require system-wide reeducation, standardization, and multidisciplinary collaboration to improve outcomes for T2DM patients.

  PublisherDOI

• Proceeding with liver transplantation in acute non-necrotizing pancreatitis: A 10-year propensity-matched cohort study

  Pancreatology · 2025-11-10 · 1 citations

  articleSenior author
  PublisherDOI

• S1051 Higher Risks With Gastrostomy Tube Placement After Esophagectomy: Evidence From the National Inpatient Sample Database

  The American Journal of Gastroenterology · 2025-10-01

  articleSenior author

  Introduction: In advanced esophageal cancer, esophagectomy may be a part of the standard of care for treatment. This morbid surgery may lead to nutritional challenges, which often necessitate feeding tube placement. The efficacy and safety of gastrostomy vs jejunostomy tube approaches in this setting remain very limited. Methods: Adults with esophageal cancer who were hospitalized for esophagectomy were extracted via the National Inpatient Sample (2016-2022). Patients under 18 years or with pre-existing gastrostomy tubes were excluded. The use of enteral feeding methods during index hospitalization was assessed for clinical characteristics across 3 groups: gastrostomy, jejunostomy, and no feeding tube placement. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included sepsis, tube malfunction, acute kidney injury (AKI), critical care utilization, length of stay, and hospital charges. Results: Among 15,365 patients who underwent esophagectomy, 12.9% received jejunostomy tubes, and 3.1% received gastrostomy tubes. The mean age and Charlson Comorbidity Index scores between the 3 groups were comparable. All cohorts were predominantly men, White, and insured through Medicare. While a higher proportion of patients undergoing jejunostomy or gastrostomy tube placement were in the 51st-75th income quartile, a higher number among those without tube placement were 1 quartile lower (25th-50th). Palliative care use was highest in those undergoing gastrostomy tube placement. Gastrostomy tube placement was associated with significantly higher odds of complications as compared to those undergoing jejunostomy tube placement, including AKI, tube malfunction, sepsis, need for critical care, and all-cause mortality. The gastrostomy tube placement group had longer hospitalizations and incurred higher hospital charges. Conclusion: Compared to jejunostomy, gastrostomy tube placement was associated with significantly worse clinical outcomes and higher resource utilization. Given the rising incidence of esophageal cancer worldwide, it is imperative to optimize enteral access strategies to improve patient care. Future prospective studies are needed to validate these findings.

  PublisherDOI

• Comparable Long-Term Liver Transplant Outcomes in Primary Sclerosing Cholangitis with and without MASLD: Last Decade Analysis of the UNOS Database

  Digestive Diseases · 2025-07-04 · 1 citations

  articleOpen accessSenior author

  INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver transplants (LT) in the USA. Despite its overlap with other indications, its intersection with primary sclerosing cholangitis (PSC) remains unexplored. METHODS: We performed a retrospective cohort study using the UNOS/OPTN database (2013-2024) to evaluate outcomes in PSC, MASLD, and PSC/MASLD. Exclusions included prior/multi-organ transplants, body mass index (BMI) <15 kg/m2, pediatric recipients, and other liver diseases. A propensity-matched analysis adjusting for age and sex was conducted. Outcomes included LT probability, waitlist survival, and post-LT graft and patient survival, assessed by Kaplan-Meier and Cox proportional hazards models. RESULTS: We included 255 PSC, 255 MASLD, and 85 PSC/MASLD patients, matched 1:3:3. BMI and diabetes rates were highest in PSC/MASLD (31.2 kg/m2; 43.5%) and MASLD (30.9 kg/m2; 54.5%) (p < 0.001). Hepatic decompensation, including ascites and encephalopathy, was more common in PSC/MASLD and MASLD than PSC (p < 0.001). On the waitlist, PSC/MASLD had the best 1-year survival (93%) but declined sharply to 70% by 4 years (95%), compared to PSC (77%) and MASLD (63%) (p = 0.02). PSC/MASLD also had the highest 5-year LT probability (52%), followed by MASLD (46%) (p < 0.001). Post-LT, patient and graft survival were similar across groups. In multivariate analysis, diabetes (HR 1.22) and life support (HR 1.39) independently predicted worse post-LT outcomes. CONCLUSIONS: PSC/MASLD had a higher transplant probability and lower waitlist survival than PSC. Posttransplant outcomes were similar across groups. Diabetes and life support independently worsened post-LT outcomes, emphasizing the need for diabetes management in MASLD and PSC/MASLD.

  PublisherOA PDFDOI

• S2570 Underuse of GLP-1 Receptor Agonists Despite Promising Evidence in Managing Post-Liver Transplant Alcohol Recidivism in Alcohol Associated Liver Disease

  The American Journal of Gastroenterology · 2025-10-01

  articleSenior author

  Introduction: Alcohol-related liver disease (ALD) is the leading indication for liver transplantation in the US, yet relapse occurs in up to 20% of patients. Recent studies suggest that incretin-based therapies (IBTs), particularly glucagon-like peptide-1 receptor agonists (GLP-1 RA), may modulate the dopamine reward pathway and enhance central gamma-aminobutyric acid (GABA) release, potentially mitigating AUD recurrence. This study aims to characterize the prevalence of GLP-1 RA initiation post-liver transplant in patients with ALD and assess its potential association with AUD recurrence. Methods: This case series utilized data from a single center tertiary U.S. transplant center and evaluated adult patients diagnosed with ALD who underwent liver transplantation between 2015 and 2025. Patients with other liver diseases, malignancies, prior organ transplants, or usage of dipeptidyl peptidase-4 inhibitors or sodium-glucose cotransporter-2 inhibitors were excluded. Primary outcomes included alcohol-related diagnoses (dependence, abuse, or any use), ALD recurrence, transplant rejection, and initiation of GLP-1 RA therapy within 1 month to 5 years post-transplant. Results: Among 802 patients (mean age 53.7 years; 33.9% woman; mean Charlson comorbidity score 5.6), 46.5% experienced ALD recurrence, 48.9% had documented alcohol use, 37.2% had alcohol dependence, and 21.6% had documented alcohol abuse. Transplant rejection occurred in 15.8% of cases, with 7.0% developing graft failure requiring re-transplant. Despite robust preclinical evidence supporting the potential role of GLP-1RA in managing AUD, only 1.5% (n = 12) of the cohort received GLP-1 RA therapy within one-year post-transplant. Among them, only 0.5% (n = 4) had documented alcohol use after initiating GLP-1 RA therapy. Conclusion: Recurrence of AUD and related complications post-transplant remains a significant burden among patients with ALD. Although data exists supporting the use of GLP-1 RA, there is a strikingly low prevalence of GLP-1 RA utilization. These findings underscore a missed opportunity and support the need for future prospective studies to evaluate the benefit of GLP-1 RAs in reducing alcohol relapse after transplant.

  PublisherDOI

• S2038 Impact of Race and Socioeconomic Disparities on Major Liver Adverse Events in Patients With Inflammatory Bowel Disease: A Study Using the National Inpatient Sample

  The American Journal of Gastroenterology · 2025-10-01

  articleSenior author

  Introduction: Inflammatory bowel disease (IBD) is associated with worse outcomes in patients with chronic liver disease (CLD). However, it remains unclear which specific complications constitute major adverse liver outcomes (MALO) and to what extent racial and socioeconomic disparities contribute to these outcomes. The aim of our study is to identify MALO in patients with both IBD and CLD, while evaluating the influence of race and socioeconomic status. Methods: This retrospective cohort study analyzed hospitalized adults with IBD and CLD using the National Inpatient Sample database (2015–2021). Demographic variables included age, sex, and race/ethnicity. Socioeconomic status included household income. Clinical variables included length of hospital stay, in-hospital mortality, and the presence of common comorbidities. Results: Among 97,628 hospitalized adult IBD patients, 4.11% had secondary CLD. Majority of IBD-CLD were White (74.94%) and from lower-income households (53.83% had income <$35,000). Racial disparities were evident, with significant differences in comorbidities such as sepsis, cholangitis, and hepatocellular carcinoma. Depression (20.18%) and anxiety (24.21%) were prevalent, especially among White patients. Multivariable regression analysis demonstrated that African Americans had higher odds of MALO compared to Whites (OR 1.42, P = 0.003). Additionally, lowest socioeconomic status (OR 1.19, P = 0.04), older age (≥50 years; OR 2.15, P < 0.001), and extended hospital stay (≥5 days; OR 1.26, P = 0.002) were independently associated with increased MALO. Female sex was associated with reduced odds of MALO (OR 0.68, P < 0.001). Conclusion: Older age, prolonged hospitalization, African American race, and lower socioeconomic status significantly increase odds of MALO in IBD patients with CLD. Interventions reducing health inequities are desperately needed to mitigate disparities amongst this patient population.

  PublisherDOI

• S1078 Oral Contraceptives Significantly Reduce the Risk of GERD, Esophagitis and Barrett’s Esophagus

  The American Journal of Gastroenterology · 2025-10-01

  article

  Introduction: Gastroesophageal reflux disease (GERD) affects over 784 million people worldwide. Hormonal contraceptives have been suggested to influence GERD risk due to their effects on gastric acid secretion and esophageal sphincter function. While combined oral contraceptives (COCs) have been more commonly associated with GERD, limited evidence exists on progestin-only contraceptives (POCs). Of women aged 15-49 years, 65% use contraception, with 1 in 4 utilizing oral contraceptive pills. Given their widespread use, this study aimed to compare the incidence of GERD and related esophageal conditions between COC and POC users. Methods: This retrospective cohort study utilized de-identified data from the TriNetX U.S. Collaborative Network, encompassing records from 67 U.S. healthcare organizations. Women aged 18-50 years with documented use of POCs, COCs, or no hormonal contraception between January and December 2014 were included. Patients with pre-existing esophageal conditions or confounding health issues were excluded. Propensity score matching was used to control for variables such as age, body mass index, alcohol use, smoking, and comorbidities. GERD, esophagitis, Barrett’s esophagus, and esophageal cancer were identified using International Classification of Diseases-10 codes, and outcomes were tracked over a 10-year period. Results: After matching, both POC and COC users had significantly lower odds of GERD, esophagitis, and Barrett’s esophagus compared to the control group. GERD incidence was lowest in POC users (9.76%) versus COC users (11.30%) and controls (12.60%). POC users also had a lower risk of esophagitis than both COC users and controls. Both contraceptive groups had reduced odds of Barrett’s esophagus, with no significant difference between them. Esophageal cancer was rare and showed no significant differences across groups. Conclusion: This study demonstrates that both POCs and COCs are associated with a reduced risk of GERD compared to controls, with POCs showing a stronger protective effect. This contrasts with previous findings suggesting estrogen increases GERD risk. The long-term design and rigorous matching in this study may explain the differing results. The protective effect may be attributed to synthetic progestins enhancing lower esophageal sphincter tone and reducing inflammation. Further clinical trials are needed to confirm these results and explore underlying mechanisms.

  PublisherDOI

• Tu1548: SEX DOES NOT INFLUENCE ANAL CANCER INCIDENCE IN LIVER TRANSPLANT RECIPIENTS

  Gastroenterology · 2025-05-01

  article1st authorCorresponding
  PublisherDOI

• S2689 Evaluating Outcomes in Patients With MASLD and Vitamin D Deficiency

  The American Journal of Gastroenterology · 2025-10-01

  articleSenior author

  Introduction: Vitamin D modulates the expression of receptors and mediators of inflammation in a cell-and-tissue-dependent manner. Patients with metabolic dysfunction-associated steatotic liver disease (MASLD) have been found to have lower levels of vitamin D compared to matched controls, with an inverse relationship observed between vitamin D levels and disease severity. This study aims to evaluate outcomes in patients with MASLD with normal vitamin D levels compared to patients with MASLD and vitamin D deficiency. Methods: This study utilized the TriNetX Research Network and included patients with MASLD or MASH between January 2006- January 2024. The cohorts were defined by a) normal vitamin D levels >30 ng/ml and b) vitamin D deficiency defined as <20 ng/ml. Propensity score matching was performed for the following covariates (age, sex, race, malignancy, heart failure, hypertension, chronic obstructive pulmonary disease, ischemic heart disease, chronic kidney disease). The primary outcomes were: mortality, hospital readmissions, intensive care unit (ICU) admissions, and development of cirrhosis at 1 year and 5-year follow-up. Results: A total of 12,204 patients with MASLD had normal vitamin D levels and 8,933 patients with MASLD had vitamin D deficiency. After 1:1 propensity matching 6,959 patients were included in each group. Patients with vitamin D deficiency were more likely to have hospital readmissions compared to patients with normal vitamin D levels at 1 and 5 years, 10% vs 6.0% (P = 0.01) and 15% vs 10% (P = 0.01), respectively. Rates of ICU care were increased in patients with vitamin D deficiency at 1 and 5 years, 2.6% vs 1.2% (P = 0.01) and 4.4% vs 2.4%, respectively. Progression to cirrhosis was not significant between groups. Mortality rates were increased in patients with vitamin D deficiency compared to patients with normal vitamin D levels at 1 and 5 years 1.5% vs 0.5% (P = 0.01) and 3.2% vs 1.3% (P = 0.01), respectively. Conclusion: Among patients with MASLD, those with vitamin D deficiency experienced significantly higher rates of hospital readmissions, ICU care, and all-cause mortality at both one- and 5-year follow-up compared to those with normal vitamin D levels. These results have identified vitamin D deficiency as a possible risk factor for worse outcomes in patients admitted with MASLD. Future studies are needed to further investigate vitamin D deficiency in patients with liver disease.

  PublisherDOI

Frequent coauthors

• Jasmohan S. Bajaj

  Virginia Commonwealth University Medical Center

  32 shared

• Kevin Houston

  University Health System

  28 shared

• Richard K. Sterling

  Virginia Commonwealth University

  22 shared

• Joel Wedd

  Virginia Commonwealth University

  18 shared

• Scott Matherly

  Virginia Commonwealth University

  18 shared

• Vinay Kumaran

  University Health System

  18 shared

• Nicole Keller

  University of Richmond

  18 shared

• S Bullock

  University Health System

  18 shared

Labs

• Vice Provost for Student AffairsPI

Awards & honors

• Healio Gastroenterology Disruptor of the Year Award 2023 (No…
• VCU Outstanding Fellow Research Scholar of the Year Award (2…
• AASLD Emerging Liver Scholars Resident Travel Award (2018)
• Georgetown University Research Day; Second Place: Resident C…
• Georgetown Medical Center SPIRIT award for service, integrit…