Apolipoprotein A4 (Apoa4) is a lipid-binding protein induced by long-chain fatty acid (LCFA) absorption in the small intestine that circulates via chylomicrons and exerts pleiotropic effects through the following receptor systems: (1) the nuclear receptor NR4A1/NR1D1-mediated SERPINA3 induction, which is linked to anti-inflammatory responses and CKD[19]; (2) αIIbβ3 integrin-dependent inhibition of platelet aggregation and thrombosis; and (3) LRP1-regulated metabolic homeostasis[20] and numerous other unidentified receptors. Here, APOA4 is linked to chronic kidney disease.