In patients with type 2 diabetes at high risk for cardiovascular disease, targeting blood sugar to normal levels reduced the risk for macroalbuminuria, but it had no impact on more significant kidney outcomes such as serum creatinine doubling or the need for dialysis or transplantation. Targeting low blood pressures or the use of fenofibrate to lower cholesterol increased the risk for doubling of serum creatinine, although it had no impact on the need for dialysis or transplantation.