COL4A4 and chronic kidney disease: 16.3-Suggestion: In individuals with heterozygous P/LP COL4A3/COL4A4 variants and no microalbuminuria, over 40 years of age, who have been informed about the risk of subsequent development of CKD and want to donate a kidney, a kidney biopsy with electron microscopy should be discussed to evaluate the risk of developing severe CKD post-donation. (Grade D, expert opinion)