Urinary peptidomics analysis reflects such CRS-associated changes, occasionally overlapping, as expected, with changes earlier observed in HF and CKD; but also alterations such as collagen type IV (COL4A2 and COL4A4), type VI (COL6A5), HUWE1, CD14, ANR17, PIGR and ROBO1 as well as a number of predicted proteases including MEP1B, MMP26, PCSK4 and KLK4, meriting further investigation in the context of CRS. The gene discussed is PCSK4; the disease is congenital rubella syndrome.