Wyatt, now 16, was first referred to nephrology at 2 years old due to a family history of ADPKD. His father and paternal aunt were diagnosed with ADPKD and chronic kidney disease at 35 and 30, respectively. His paternal grandma died at 70 due to renal failure. Despite this, Wyatt was healthy, with no history of haematuria or urinary tract infection, and his growth was normal. At first glance, the question posed to this case appears straightforward, yet the answer is more complex than anticipated.