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Summary
The nephrotic syndrome is the only hypoalbuminaemic state frequently associated with hyperlipidaemia. In the presence of a negative nitrogen balance, hyperlipidaemia is metabolically inappropriate and reflects the result of persistent breakaway from free fatty acid control. This lipid abnormality may result in the premature development of ischaemic heart disease in patients in whom it is not possible to control the primary renal abnormality. The authors suggest that future work should be directed towards thyroxine and insulin metabolism in nephrotic states.