We would therefore propose that even in the absence of overt clinical features included in the spectrum of WT1 pathogenic variant, the investigation of a germline WT1 pathogenic variant should be considered in the presence of bilateral kidney tumours (which may include any combination of WT or precursor lesion), unilateral multifocal disease, age under 12 months, stromal predominance of the lesion in an infant, and any indication of persistent kidney dysfunction or hypertension. Here, WT1 is linked to kidney neoplasm.