There is a randomized, double-blind, placebo-controlled, multicenter phase 2 trial in Japan (TSUBAKI trial) enrolling 120 patients with CKD and type 2 diabetes without identified risk factors for fluid overload, such as baseline brain natriuretic peptide (BNP) >200 pg/mL and prior history of heart failure. Here, NPPB is linked to type 2 diabetes mellitus.