Although recent pharmacological advancements, such as SGLT2 inhibitors and conventional renin–angiotensin–aldosterone system (RAAS) inhibitors, have successfully reduced diabetes-associated CVD and morbidity and ameliorated CKD progression in T2D patients, there still exists considerable risk for ESRD progression, paving the way for newer therapeutics or adjuncts such as microbiome-modulating nutraceuticals [98]. This evidence concerns the gene REN and type 2 diabetes mellitus.