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The patient was discharged without treatment on hospital day 19 due to financial constraints and subsequently died after 7 days. mNGS is an excellent diagnostic tool when specific pathogens are undetected by traditional assays. mNGS is an excellent diagnostic tool when specific pathogens are undetected by traditional assays. Aristolochic acid nephropathy (AAN) is a type of drug-induced nephropathy that may result in acute kidney injury and is associated with a potentially progressive course of kidney fibrosis and upper tract urothelial