For COL4A3 and COL4A4, the mode of inheritance has traditionally been reported as recessive, but next-generation sequencing studies have reported about 20% to 30% of patients with dominant disease.49, 50, 51, 52 Of 3 pathogenic heterozygous missense variants in COL4A3 (ie, rare variant reported in other individuals with kidney disease), all were predicted to be deleterious by at least 10 of 12 in silico programs (Table 1; Item S2). Here, COL4A4 is linked to kidney disorder.