Gastroenteritis: This is a common cause of nausea, vomiting, and diarrhea in the general population, and patients with chronic kidney disease (CKD) are not exempt. The symptoms can be exacerbated by the patient's underlying condition, which may affect fluid and electrolyte balance.

Medication Side Effects: Patients with CKD are often on multiple medications, some of which can cause gastrointestinal side effects such as nausea, vomiting, and diarrhea. Examples include phosphate binders, iron supplements, and certain blood pressure medications.
Electrolyte Imbalance: CKD can lead to disturbances in electrolyte levels, such as hyperkalemia, hypokalemia, hyperphosphatemia, or hypocalcemia, which can cause nausea, vomiting, and diarrhea.
Uremia: As CKD progresses, the buildup of uremic toxins can cause a range of symptoms, including nausea, vomiting, and diarrhea, due to the toxic effects on the gastrointestinal system.

Acute Kidney Injury (AKI): Superimposed on CKD, AKI can worsen symptoms of nausea, vomiting, and diarrhea due to a more rapid decline in renal function, leading to a buildup of toxins.
Sepsis: Infection can cause nausea, vomiting, and diarrhea, and in a patient with CKD, sepsis can quickly lead to AKI or worsen existing renal function, making prompt diagnosis critical.
Hypercalcemia: Elevated calcium levels can be associated with CKD, particularly in those with secondary hyperparathyroidism, and can cause gastrointestinal symptoms.

Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, including the gastrointestinal tract, which can lead to symptoms like nausea, vomiting, and diarrhea. It is rare but can be associated with CKD.
Gastrointestinal Involvement in Systemic Diseases: Certain systemic diseases that can cause CKD, such as systemic lupus erythematosus (SLE) or scleroderma, can also involve the gastrointestinal system, leading to nausea, vomiting, and diarrhea.