To the Editor We read with great interest the results of the randomized clinical trial conducted by Cohen et al1 demonstrating the superiority of Roux-en-Y gastric bypass (RYGB) compared with optimal medical treatment regarding remission of albuminuria in patients with type 2 diabetes mellitus, obesity, and early-stage chronic kidney disease (CKD), primarily driven by the significant reduction in body mass index.1 Marginally significant improvement in glycemic control, along with no difference in blood pressure reduction, were shown for RYGB-treated patients compared with those randomized to pharmacologic intervention only, underlining the significance of induced weight loss regarding the assessed kidney end point.1