The author reflects on the study of a patient with myonephropatic metabolic syndrome after bilateral aortoiliac bypass. He presented the findings of the study. He also commented that the researcher was correct to point out that the blue-toe syndrome is an avoidable complication when the outflow vessel is clamped before the manipulation of atherosclerotic aorta. He also enumerated several issues arising from the concurrence of the myonephrotic metabolic and blue-toe syndromes.