In HIV-infected patients, acute tubular necrosis (ATN) secondary to hypotension or sepsis is the most common cause of AKI, with WHO stage IV disease, low CD4 counts and hypoalbuminaemia all associated with higher mortality.3 Many commonly used medications have nephrotoxic potential (Table 2)12, varying from predictable, cumulative dose-dependent nephrotoxicity to idiosyncratic dose-independent toxicity, or both.4 This evidence concerns the gene CD4 and acute kidney injury.