Endothelial dysfunction may arise from inflammation, dyslipidemia, hypoalbuminemia, and oxidative stress.40 In NS, these mechanisms are particularly relevant, as hypoalbuminemia and dyslipidemia are well-known complications,41 and NS is associated with a proinflammatory state with elevated fibrinogen, IL6, and TNFα. The gene discussed is TNF; the disease is metabolic syndrome.