The changing epidemiology of acute kidney injury syndromes in the face of emerging respiratory viral pandemic illnesses

In this issue, Birkelo et al. performed a rigorous analysis of acute kidney injury (AKI) differences in patients hospitalized with coronavirus disease 2019 versus influenza. Coronavirus disease 2019 AKI was more severe, with worse outcomes, than influenza, despite adjustment for confounders. Their findings highlight the need for development of a new category of AKI syndrome, “viral pandemic–associated AKI,” in which a more varied pathophysiological approach to AKI would combine with consideration of overcoming future surge-related resource shortages.