After adjusting for well-known and suspected risk factors, including sex, age of DM onset, duration of diabetes, smoking status, insulin treatment, hyperlipidemia, baseline eGFR, MAP, BMI, anemia, urinary protein, and HbA1c, the positive association between the TyG index and ESRD remained stable, indicating that baseline TyG index was an independent predictor for ESRD in patients with T2DM and CKD. The gene discussed is INS; the disease is anemia.