The Evaluation of the Drug R3R01 for the Excretion of Protein in the Urine in Patients With Diabetic Kidney Disease.

An increasing amount of evidence suggests that lipid dysmetabolism and accumulation in the kidneys play a central role in the pathogenesis of kidney disease. This lipotoxicity, in turn, may contribute to the development of albuminuria and chronic kidney disease. One may surmise that interventions that reduce or prevent the progression of kidney lipid accumulation protect against the progression of kidney disease, including diabetic kidney disease (DKD). Therefore, it is possible inhibiting cholesterol absorption, might effectively protect against lipid accumulation and related disease in the kidneys. R3R01 is an ATP-binding cassette transporter A1 (ABCA1) inducer, which increases the efflux of cholesterol from the intracellular space in the kidney. Persons with type 2 diabetes with moderate and severe albuminuria have a poor renal and cardiovascular prognosis. As albuminuria is viewed both as a risk marker but also as a target for intervention, any treatment with antiproteinuric effects could be beneficial. The role of ABCA1 inducer treatment on kidney parameters in diabetic kidney disease is not known. By investigating the impact of ABCA1 inducer treatment on albuminuria, it will be determined whether this intervention may represent a future treatment option. This study is a single center, double-blind, placebo controlled, parallel group randomized (2:1) study, in 60 people with type 2 diabetes with moderate or severe albuminuria and estimated glomerular filtration rate (eGFR) above 30 ml/min/1.73m2. 40 people will take R3R01 whilst 20 people receive the placebo. The study's primary objective is to evaluate the effect of 12 weeks treatment with R3R01 on albuminuria in the study population. In addition to a 12 week treatment period, there will be a follow-up period of approximately 24 weeks (168 days). The expected total duration of study participation is up to 36 weeks for each patient.