Kaseda R, et al. - Researchers undertook this study to assess lipid trafficking and inflammatory response of macrophages exposed to lipoproteins from subjects with moderate to severe chronic kidney disease (CKD). Furthermore, they looked for the potential benefits of activating cellular cholesterol transporters via liver X receptor (LXR) agonism. They found that foam cell formation was promoted by moderate to severe impairment in kidney function. This indicated impairment in cholesterol acceptor function of HDL isolated from patients with stage 3–4 CKD (HDL^CKD). Furthermore, LXR agonism-triggered activation of cellular cholesterol transporters improved but did not normalize efflux to HDL^CKD. However, LXR agonism actually increased the pro-inflammatory impacts of HDL^CKD via activation of Toll-like receptors and extracellular signal regulated protein kinases 1/2 (ERK1/2) pathways.