United States securities and exchange commission logo 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.