PCSK9 and chronic kidney disease: The increase of its level is influenced by the activation of platelets,27 vascular stiffness,28 and coronary plaque instability.29 Therefore, the level of PCSK9 is not a predicting factor of cardiovascular disease in CKD patients at early stages, such as stages 2–3 of CKD,16,30 but in patients with stages 4–5 of CKD.