To explore the role of SP-A and exosomes in the sepsis-induced AKI, we used exosomes to treat WT and KO primary renal tubular epithelial cells (RTECs), and we found that the septic serum-derived exosomes can induce the RTECs apoptosis, pyroptosis, and SP-A down-regulation, and the cell damage was more serious in the KO group. The gene discussed is SFTPA2; the disease is acute kidney injury.