The article presents a clinical case of toxininduced acute kidney injury. The authors analyzed the cause of the event, revealed the pathogenesis of toxin injury of the kidneys, and described the main principles of treatment. The authors used this clinical case to show the importance of timely renal replacement therapy and the influence of comorbid pathology on disease development. The onset of acute kidney injury in patients with surrogate alcohol intoxication manifested as combined kidney and liver injury was described. The article may be of interest to doctors of all specialties, especially for therapists and surgeons who are the first to reveal acute kidney injury and their choice of adequate management ultimately determines the outcome.