Intervention Using Vitamin D for Elevated Urinary Albumin Treated With Losartan in Diabetes (IDEAL)

Inclusion Criteria: 1. Diagnosis of T2DM requiring treatment with at least one oral hypoglycemic medication or insulin 2. Macroalbuminuria as defined as the presence of a UACR greater than 300 mg/gm creatinine (30 mg/mmol creatinine) on two occasions in the last six months 3. Estimated eGFR of 30 to 90 mL/min/1.73 m2 Exclusion Criteria: 1. Positive Pregnancy Test or planning pregnancy in the subsequent 18months (if female) 2. Serum Calcium \> 2.45 mmol/L (9.8 mg/dL) 3. Serum Phosphorus \> 1.78 mmol/L (5.5 mg/dL) 4. Serum Potassium \> 5.5 mmol/L (5 mEq/L) 5. Parathyroid hormone \< 20 pg/mL or \> 500 pg/mL 6. Hemoglobin A1C \> 12% 7. 25-OH Vit D \> 50 ng/mL 8. Poorly controlled hypertension defined as systolic blood pressure \>= 180 mm Hg or diastolic blood pressure \>= 110 mm Hg 9. History of kidney stones 10. History of severe disease like chronic liver disease 11. Active malignancy 12. Active granulomatous diseases like turburculosis and sarcoidosis 13. Recent diagnosis of acute renal failure within 3 months of screening visit 14. Likelihood of renal replacement therapy within 1 year 15. History of parathyroidectomy 16. Currently taking calcitriol or 1,25-dihydroxyvitamin D analog 17. Currently taking calcitonin, bisphosphonates, cinacalcet, teriparatide, glucocorticoids or other drugs that may affect calcium or bone metabolism (subjects may be taking calcium containing phosphate binder or other phosphate binder. Subjects may also be taking stable dose of estrogen/progestin) 18. History of osteoporosis or other bone disorder requiring calcitriol therapy 19. History of allergic reaction to calcitriol, paracalcitol, hectoral, or other 1,25-dihydroxyvitamin D analogs 20. History of allergic reaction to losartan or any other angiotensin receptor blocker therapy 21. Evidence of drug or alcohol abuse