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                          April 12, 2021

       Joseph Gardner
       President and Founder
       Aerpio Pharmaceuticals, Inc.
       9987 Carver Road
       Cincinnati, OH 45242

                                                        Re: Aerpio
Pharmaceuticals, Inc.
                                                            Registration
Statement on Form S-3
                                                            Filed April 8, 2021
                                                            File No. 333-255129

       Dear Mr. Gardner:

              This is to advise you that we have not reviewed and will not
review your registration
       statement.

               Please refer to Rules 460 and 461 regarding requests for
acceleration. We remind you
       that the company and its management are responsible for the accuracy and
adequacy of their
       disclosures, notwithstanding any review, comments, action or absence of
action by the staff.

                                                        Please contact Margaret
Schwartz at 202-551-7153 with any questions.




                          Sincerely,


                          Division of Corporation Finance

                          Office of Life Sciences
       cc:                                              James H. Xu, Esq.