An international study, performed by 24 hospitals and clinics from 13 different countries, among them the Vall d´Hebron Institut of Research (VHIR), with Drs. Rafael Simó and Cristina Hernández, shows that the levels of lipids in diabetic patients are clearly associated with the risk of developing renal failure. The study was published in the journal " "http://circ.ahajournals.org/content/129/9/999.long" Circulation. The goal of the research was to determine whether triglyceride and cholesterol levels in the plasma are associated with diabetic kidney disease (nephropathy) and vision loss (retinopathy). The study shows that triglyceride and HDL-C levels are strongly, and independently, associated with the risk of developing microvascular disease, and in particular, kidney failure. This means that, even if the levels of “bad” cholesterol (LDL-C) in these patients are controlled by drugs, the probability that they will develop kidney failure is increased if they have high levels of triglycerides, whereas HDL-C diminish it.Triglycerides are a type of fat with a different function than cholesterol (they are a source of energy) and, when in high levels, can cause artherosclerosis and heart disease. As Dr. Simo points out, “controlling the levels of triglycerides not only decreases the cardiovascular risk but also curbs kidney disease, which is the main cause of end-stage renal disease and transplantation, with the economic cost it implies for the health system”.The risk of retinopathy is also associated with triglyceride levels, but the association is weaker and may depend on other factors such as hypertension and glycosilated hemoglobolin levels. For the authors, the strength of this study relies on its global scope: the multiple sites and the size of the sample (2635 cases and 3683 controls) supports wide applicability of the results across different regions and ethnical groups.Diabetes mellitus is the main cause of kidney failure and blindness in adults. Its worldwide prevalence is on the rise, and the complications associated to the disease are also expected to increase. Even though glucose and tension control can limit the development of diabetic microvascular disease, the residual risk for these complications remains high. Therefore, it is necessary to identify other targets and treatments to make progress in slowing the development of diabetic kidney disease and retinopathy. In this context, the results from this study are have considerable importance in support of the need to establish additional lipid targets other than LDL-C to benefit the diabetic population at high residual risk for microvascular disease.