Two landmark multi-center clinical trials are actively performed in the division, including the Diabetes Prevention Program. Outcomes Study (DPPOS) and Look AHEAD (Action for Health in Diabetes. Ongoing Investigator-initiated clinical trials include testing whether high dose spironolactone is effective for diuretic resistant acute decompensated heart failure and assessing antibiotics for prevention of exit site infection and peritonitis in peritoneal dialysis patients as a Quality Improvement Project. In Addition, our faculty participate in several industry-sponsored clinical trials on a wide spectrum of diseases including acute kidney injury and diabetic nephropathy. We are initiating a new investigator-initiated multi-center clinical trial incorporating a multi-omic approach with a novel anti-fibrotic agent for progressive kidney diseases.