Variants causing “later-onset” phenotypes were more prevalent in patients with disease-onset ≥ 60 years (56% vs. 8.3%; P ≤ 0.001), which include genetic variants in: IFT140, ALG5, ALG9, DNAJB11, COL4A5 in females, monoallelic COL4A3, and the UMOD p.Thr62Pro variant, associated with delayed onset of kidney failure compared with “typical” variants (hazard ratio: 0.52; 95% confidence interval: 0.27–0.98; P = 0.043). The gene discussed is COL4A3; the disease is kidney failure.