COL4A3 and Renal insufficiency: It is known that heterozygous mutations in the COL4A3 gene are associated with benign forms of familiar proteinuria, which are usually neither progressive nor lead to renal failure.[22] Looking at all the cases described previously, the first clinical manifestation of ARAS may appear as ephritic syndrome during pregnancy, as pregnancy-related hyperfiltration may acutely worsen renal function.