Second, this study suggests a superiority of patisiran over tafamidis among patients with high-grade proteinuria; however, because of the small sample size, we cannot rule out a positive effect of tafamidis in patients in whom tafamidis was associated with patisiran, or in the long-term in patients with milder renal disease, as shown in previous case series.27, 28, 29 Third, the use of nephroprotective drugs, renin-angiotensin-aldosterone system and sodium-glucose transport protein 2 inhibitor, was uneven over the years in our patients, and not always reported in medical charts. This evidence concerns the gene REN and kidney disorder.