Exhibit 5.2

Troutman Pepper Hamilton Sanders LLP
401 9th Street, N. W., Suite 1000
Washington, DC 20004-2134
troutman.com

XORTX Therapeutics Inc.

3710 – 33rd Street NW

Calgary, Alberta, T2L 2M1

Canada

Re: XORTX Therapeutics Inc. - Prospectus Supplement to Registration Statement on Form F-3 (File No. 333-269429)

Ladies and Gentlemen:

We have acted as United States counsel to XORTX Therapeutics Inc., a corporation organized under the laws of British Columbia, Canada (the "Company"), in connection with a Prospectus Supplement to a Registration Statement on Form F-3 (File No. 333-269429) (the "Prospectus Supplement") filed by the Company with the United States Securities and Exchange Commission (the "Commission") under the United States Securities Act of 1933, as amended (the "Securities Act"), relating to the offer and sale by the Company of an aggregate of 320,000 common shares of the Company, no par value per share (the "Shares"), and pre-funded warrants to purchase an aggregate of 490,810 common shares at an exercise price of $0.00001 per share (each, a "Pre-Funded Warrant"), exercisable until such time as the Pre-Funded Warrants are exercised in full, subject to adjustment as provided in the Pre-Funded Warrants, pursuant to that certain Securities Purchase Agreement, dated October 17, 2024 (the "Securities Purchase Agreement"), between the Company and the purchaser thereunder.

This opinion letter is furnished to you for filing with the Commission pursuant to Item 601 of Regulation S-K, promulgated under the Securities Act.

We have examined such documents and have reviewed such questions of law as we have considered necessary or appropriate for the purposes of our opinions set forth below. In rendering our opinions set forth below, we have assumed the authenticity of all documents submitted to us as originals, the genuineness of all signatures and the conformity to authentic originals of all documents submitted to us as copies. We have also assumed the legal capacity for all purposes relevant hereto of all natural persons and, with respect to all parties to agreements or instruments relevant hereto, that such parties had the requisite power and authority (corporate or otherwise) to execute, deliver and perform such agreements and instruments, that such agreements and instruments have been duly authorized by all requisite action (corporate or otherwise), executed and delivered by such parties and, except to the extent expressly stated in the opinions contained herein, that such agreements and instruments are the valid, binding and enforceable obligations of such parties. As to questions of fact material to our opinions, we have relied upon certificates or comparable documents of officers and other representatives of the Company and of public officials.

Based on the foregoing, and assuming that (i) the Registration Statement and all amendments thereto (including post-effective amendments) is and will continue to be effective under the Securities Act, (ii) the Company is duly incorporated and is validly existing and in good standing under the laws of the jurisdiction of its organization, (iii) the Securities Purchase Agreement and the Pre-Funded Warrants will or have been duly authorized and validly executed and delivered by the Company, and (iv) any common shares issuable upon exercise of the Pre-Funded Warrants being offered or sold will be duly authorized, created and, if appropriate, reserved for issuance upon such exercise, we are of the opinion that the Pre-Funded Warrants, when issued and delivered against payment of the consideration therefor, as contemplated in the Prospectus Supplement and in accordance with the terms of the Securities Purchase Agreement, will constitute valid and binding obligations of the Company, enforceable against the Company in accordance with their terms.

Our opinions set forth above are subject to the following qualifications and exceptions:

Our opinions expressed above are limited to the corporate laws of the State of New York.

We are furnishing this opinion in connection with the filing of the Prospectus Supplement, and hereby consent to the reference to our firm under the headings "Legal Matters" in the Prospectus Supplement. In giving this consent, we do not admit that we are within the category of persons whose consent is required under Section 7 of the Securities Act or the rules and regulations of the Commission thereunder.