The beneficial effects of HMG-CoA reductase inhibition in models of progressive glomerular injury may not all be due to reductions in circulating lipoproteins and decreases in glomerular lipoprotein deposition. Indeed, HMG-CoA reductase inhibitors may have direct effects on glomerular mesangial cells that could explain the amelioration of renal injury. Specifically, HMG-CoA reductase inhibitors block the synthesis of isoprenoids that are necessary for mesangial cell proliferation and other important cell functions. Thus, protein isoprenylation may play a critical role in the pathogenesis and treatment of lipid-induced glomerular injury.