COL4A5 and Nephropathy: 20.4-Suggestion: Where kidney donation is considered by an individual heterozygous for a single P/LP variant in COL4A3, COL4A4, or COL4A5 aged over 40 years, in the absence of albuminuria or reduced eGFR, a kidney biopsy could be performed to detect evidence of subclinical kidney damage (i.e. scarring greater than what would be normal for their age) that would preclude donation.