Among diabetic nephropathy patients in the Reduction of Endpoint in NIDDM with the Angiotensin II Antagonist Losartan (RENAAL) study [52], Hb <11.3 g/dL roughly doubled the risk of renal replacement onset (hazard ratio = 1.99, 95% CI 1.34 to 2.95, 3.4 years mean follow-up), and every 1 g/dL Hb decrease increased renal replacement risk by 11% [52]. This evidence concerns the gene GSTM1 and diabetic kidney disease.