The available studies provide an apparent compilation of diverse and solid research evidence on the possible nephroprotective role of trimetazidine. However, large, randomized, placebo-controlled, preferably multicentre studies are necessary to confirm this hypothesis in non-dialyzed, chronic renal failure and haemodialyzed patients. The extent of the challenge would also be related to specific molecular parameters chosen to demonstrate nephroprotection in the case of trimetazidine.