Impact of Silymarin Adjunct Therapy on Proteinuria in Type 2 Diabetic Patients on RAS Inhibitors

Inclusion Criteria: * Patients aged 35-70 years. * Both male and female with Type II diabetes. * Overt proteinuria defined by urinary albumin excretion \> 300 mg/24 hr. in 2 consecutive determinations despite treatment with highest FDA recommended doses of an angiotensin converting enzyme inhibitor or angiotensin receptor blocker for at least 6 months. * Treatment of hyperglycemia with (but not limited to) an oral hypoglycemic agent or insulin (If a SGLT2 inhibitors is used, stable dose for at least 3 months). * Treatment of hypercholesterolemia with (but not limited to) one medication from the class statins. * Patients using stable dose of Non-Dihydropyridine Calcium Channel Blockers for at least 6 months as antihypertensive. * Presence of diabetic retinopathy. * Signing informed consent. Exclusion Criteria: * Type I diabetes. * Advanced chronic kidney disease defined by estimated GFR \< 30 ml/min/1.73 m2 * Severely uncontrolled diabetes defined by HbA1C \> 10%. * Uncontrolled hypertension defined by SBP \>140 mmHg or DBP \>90 mmHg despite antihypertensive therapy. * Patients with organ transplant history. * Secondary forms of hypertension with defined etiology other than diabetes mellitus. * Other renal diseases. * Chronic Heart Failure with NYHA class III or IV. * Active infection. * Pregnancy. Use of one of the following medications within 2 months prior to enrollment in the study: * Non-steroidal anti-inflammatory agents. * Antioxidants supplements including vitamin…