The hidden burden of kidney damage in chylomicronemia syndromes

Background It has been recognized that hypertriglyceridemia (HTG) is associated with kidney damage. Monogenic and polygenic causes of extreme HTG characterized by severe chylomicronemia (TG > 885 mg/dl or 10 mmol/L) constitute unique models to investigate the potential nephrotoxic effects of sustained and severe exposure to HTG. Methods This study had two components: (1) kidney biopsies of three patients with severe chylomicronemia and proteinuria were analyzed; (2) a cross-sectional review of the medical files of two independent cohorts of patients with the Familial Chylomicronemia Syndrome (FCS) or Multifactorial Chylomicronemia Syndrome (MCS) followed in Italy and Canada was performed. Renal involvement was defined by the presence of proteinuria, reduced eGFR (