Additional testing can be considered as clinically indicated, including hemoglobin A1c for those with diabetes or overweight/obesity (in this case, A1c was checked given her obesity and family history of diabetes) and urine albumin to creatinine ratio (UACR) for those with CKM stage 2 and above.2 The gene discussed is ALB; the disease is obesity due to melanocortin 4 receptor deficiency.