Two previous reports in smaller groups (n = 15 Korean patients with nephrotic syndrome, i.e. proteinuria >3.5g/d, and n = 39 patients from the Netherlands with protein excretion of 1.9 [0.9–3.3] g/day) of patients with marked proteinuria observed rises in PCSK9 [24,25]. Here, PCSK9 is linked to nephrotic syndrome.