Acute kidney injury (AKI) increases morbidity, mortality, and health expenses. Its incidence is higher in critically ill patients. During the SARS-COV-2 pandemic, a higher incidence of AKI and requirement of renal replacement therapy (RRT) was evidenced, with mortality higher than 80%, and is considered in some centers as a criterion for palliative management. Previous studies have compared the incidence and risk factors for AKI and RRT between COVID-19 and other viral infections. Management was extrapolated from septic AKI; however, the pathophysiology, clinical course, and outcomes appear to be different.