After full multivariable adjustment, the HRs for kidney failure associated with the second, third, and fourth quartiles versus the first quartile of the Lp(a) distribution were 1.24 (95% CI, 0.94-1.65), 1.61 (95% CI, 1.22-2.14), and 1.33 (95% CI, 1.00-1.77), respectively. This evidence concerns the gene LPA and kidney failure.