A 76-year-old man with a history of hypertension was admitted to nephrology on 25 November 2022 due to nephrotic syndrome, presenting with a serum albumin concentration of 15 g/L and an ACR of 10 g/g, complicated by acute renal failure with a serum creatinine level of 132 μmol/L. The gene discussed is ALB; the disease is nephrotic syndrome.