Considering the low estimated glomerular filtration rate (eGFR) and high urinary protein/creatinine ratio (11.04 g/g Cre), urinary N-acetyl-β-d-glucosaminidase (420.3 U/g Cre), and β2-microglobulin/creatinine ratio (149 μg/g Cre) (Table 1), the patient was presumptively diagnosed with acute tubular necrosis with metabolic acidosis (anion-gap 23.5 mmol/L). The gene discussed is HLA-G; the disease is acute kidney tubular necrosis.