Background: It’s unclear the exact level of serum urate acid (SUA) which can prevent renal function worse although all internists has been known the target of blood glucose, blood pressure and lipid in diabetes. It’s time to aim for a reasonable SUA target to prevent renal failure in diabetes.
Methods: Using the physical examination results of 3427 diabetic patients in Jiangchuan Community, Shanghai, China, the relationship between SUA and estimated glomerular filtration rate (eGFR) decline was analyzed, and the appropriate cut-off point for SUA to predict eGFR decline was determined. Meanwhile, the population attributable risk proportion (PARP) of eGFR decline in diabetic patients above this SUA cut-off point was calculated.
Results: eGFR decreased accompany with the increased SUA level and was negatively associated with the level of SUA significantly. After adjusting for potential confounders, SUA also was an independent risk factor of eGFR decline. The best appropriate SUA point, predicting eGFR decline obtained by ROC curve, was 326.5μmol/L which may prevent from eGFR decline in 33% male patients and 355.5μmol/L which may prevent from eGFR decline in 18% female patients. Compared with SUA>326.5μmol/L male and SUA>355.5μmol/L female group respectively, the relative risk of eGFR decline in SUA≤326.5μmol/L male and SUA≤355.5μmol/L female group is decreased significantly.
Conclusions: SUA is an impotant risk factor for eGFR decline in diabetes. 326.5μmol/L in male and 355.5μmol/L in female may be used as the reasonable SUA target to retard renal function to worse in Chinese diabetes.