Until recently, prevention of DKD progression was based on strict blood pressure (BP) control, using renin–angiotensin system blockers that simultaneously reduce BP and proteinuria, adequate glycemic control and control of cardiovascular risk factors (dyslipidemia, obesity and smoking), as well as nephrotoxic drug avoidance [6,8,9] (Table 1). This evidence concerns the gene REN and obesity due to melanocortin 4 receptor deficiency.