Among the known responses is increased production of heat shock proteins (HSP) and antibodies against HSP (anti-HSP) which contribute to release of proinflammatory cytokines, a potentially protective mechanism.3 The kidney is among the target organs of concern, based on the increasing evidence of a relationship between heat exposure and chronic kidney disease of unknown cause (CKDu).4 Few empirical human studies have examined the role of the HSP pathway or its involvement in the pathophysiology of heat-associated kidney injury under actual field conditions of extreme heat and exertion. The gene discussed is HSP90B2P; the disease is medical procedure.