MGPT designed for the indication of CyKD can vary in gene content and may not include genes associated with conditions considered within the ADPKD or ARPKD spectrums or disease mimics, such as ALG5, ALG6, ALG8, ALG9, CLI2, COL4A3, COL4A4, COL4A5, DNAJB11, FLCN, GANAB, IFT140, LRP5, HNF1B, NEK8, OFD1, TSC1, and TSC2. 13,15,20,34,35 Although most clinical genetic testing laboratories include genes on their panels based on well-established gene-disease association, some laboratories may also include genes with limited or emerging evidence.36 This evidence concerns the gene COL4A4 and autosomal dominant polycystic kidney disease.