One of the major determinants of the prognosis of NPS is kidney involvement, which is thought to be caused by arrested development of podocytes and glomeruli due to a pathogenic variant of LMX1B. NPS with kidney involvement has a broad spectrum of severity, ranging from asymptomatic proteinuria and/or hematuria to symptomatic kidney failure4. Here, LMX1B is linked to nail-patella syndrome.