If a patient is diagnosed with a disease, such as renal failure, and it simply doesn't make sense given his risk factors, question why. Always try to find out why. Never accept the answer "just because". If a young man comes in with renal failure, with an intrinsic pattern (BUN/creatinine ratio < 20/1), with no diabetes or hypertension, check his eyes...and check them good! Alport syndrome is an X-linked inherited condition comprised of nephritis (which can lead to renal failure), cataracts, and hearing loss. This is one time when a referral to an ophthalmologist is key.