The data from patients with diabetic nephropathy who enrolled in the Reduction of End points in Non-insulin-dependent diabetes with the Angiotensin II Antagonist Losartan (RENAAL) trial or the Irbesartan Diabetic Nephropathy Trial (IDNT) showed no relationship between bicarbonate level and cardiovascular events, heart failure (Schutte et al., 2015). Here, AGT is linked to diabetic kidney disease.