This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The prevalence of chronic kidney disease (CKD) is growing at an alarming rate and discovering when common complications develop including insulin resistance is critical to our ability to anticipate morbidity and mortality and treat patients more effectively. Insulin resistance has been associated with the development of cardiovascular risk factors including hypertension, dyslipidemia, inflammation and perhaps accelerated progression of CKD. Such risk factors in the setting of early renal disease merit a pilot study of a potential intervention to reverse insulin resistance. There are no specific guidelines included in Kidney Disease Outcome Quality Initiative (K-DOQI) that address treatment of insulin resistance due to CKD. The demonstration that thiazolidinedione (TZD) therapy or that telmisartan, an angiotensin II receptor blocker with novel properties, reverses insulin resistance in CKD could provide a basis for long-term therapy that attenuates the complications and prognosis of CKD.