To the Editor We read with interest the study published by Cohen et al.1 This was a randomized clinical trial comparing the benefits of Roux-en-Y gastric bypass (RYGB) with best medical treatment (BMT) for chronic kidney disease in patients with type 2 diabetes and grade 1 obesity (body mass index of 30-35; calculated as weight in kilograms divided by height in meters squared).1 The authors concluded that RYGB is more effective at achieving microalbuminuria remission after 24 months and demonstrated it is a safe procedure with similar adverse effects to medical management.