Background Diabetic kidney disease (DKD), a common microvascular complication of diabetes mellitus (DM), is always asymptomatic until it develops to the advanced stage. Thus, we aim to develop a nomogram prediction model for progression to DKD in newly diagnosed type 2 diabetes mellitus (T2DM). Methods This was a single-center analysis of prospective data collected from 521 newly diagnosed patients with T2DM. All related clinical records were incorporated, including the triglyceride-glucose index (TyG index). The least absolute shrinkage and selection operator (LASSO) was used to build a prediction model. In addition, discrimination, calibration, and clinical practicality of the nomogram were evaluated. Results In this study, 156 participants were incorporated as the validation set, while the remaining 365 were incorporated into the training set. The predictive factors included in the individualized nomogram prediction model included 5 variables. The area under the curve (AUC) for the prediction model was 0.826 (95% CI 0.775 to 0.876), indicating excellent discrimination performance. The model performed exceptionally well in terms of predictive accuracy and clinical applicability, according to calibration curves and decision curve analysis. Conclusion The predictive nomogram for the risk of DKD in newly diagnosed T2DM patients had outstanding discrimination and calibration, which could help in clinical practice.
Introduction: PD-1 inhibitor, an immune checkpoint inhibitor (ICI), is currently the standard first-line treatment for advanced non-small cell lung cancer (NSCLC). Immune-related adverse effects (irAEs), on the other hand, limit their use. Acid-suppressive drugs (ASDs), including proton pump inhibitors (PPIs) and histamine 2 receptor antagonist (H2RA), are well known as common concomitant drugs in the treatment of cancer. When coupled with ICIs, however, PPIs may increase the incidence of renal adverse events (AEs). The objective of this paper is seeing how commonly individuals with NSCLC developed acute kidney disease and renal dysfunction (AKD) after receiving PD-1 inhibitors and PPIs combined. Methods: This study is a randomized, assessor- blinded, controlled clinical trial. Participants who are diagnosed with NSCLC, and taking PPIs or H2RA are randomly assigned to the intervention (using PPIs) and control (using H2RA) groups for 12 weeks in a ratio of 1: 1, and will be followed up for another 12 weeks after treatment. The primary outcome is to explore whether there is a difference in the occurrence of renal AEs between patients with NSCLC treated with PPIs and those without PPIs. Discussion: Our findings will have significant implications for AKD prevention and control in the PD-1 inhibitor-treated patients with NSCLC. In addition, it may be valuable to improve policy development and PPIs clinical practice guidelines across China. Trial registration: ClinicalTrials.gov ChiCTR2200057366. Registered on March 9, 2022
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