NAD Augmentation in Diabetes Kidney Disease

This trial is studying whether boosting levels of NAD (a natural molecule involved in cell energy and repair) can help protect the kidneys in people with type 2 diabetes who already have kidney damage. NAD levels drop in kidney disease, and this study tests if raising them slows the decline. **You may be eligible if...** - You have type 2 diabetes (confirmed by records, blood tests, or medications) - Your urine tests show a moderate to high amount of protein — a sign of kidney damage - Your kidney function (eGFR) is above 30 - Your blood sugar control is not extremely poor (HbA1c under 9%) - You speak English or Spanish **You may NOT be eligible if...** - You have severe kidney disease (eGFR under 30) - You have type 1 diabetes or certain other hormonal conditions - You have active cancer or serious liver disease - You are pregnant or planning to become pregnant Talk to your doctor to see if this trial is right for you.