Table 3. Demographics, Clinical Characteristics, and Outcomes of Time to CRRT Initiation and VO Subphenotypesa.
| Variable | Early CRRTb | Late CRRTc | P valued | ||
|---|---|---|---|---|---|
| <10% VO (n = 378) | ≥10% VO (n = 136) | <10% VO (n = 193) | ≥10% VO (n = 268) | ||
| Age, median (IQR), y | 10.6 (2.8-16.0) | 3.6 (0.9-10.6) | 13.0 (5.7-16.6) | 3.7 (0.8-12.9) | <.001 |
| Admission weight, median (IQR), kg | 37.7 (14.1-63.0) | 15.3 (9.3-33.4) | 46.7 (22.5-67.4) | 16.1 (8.3-36.7) | <.001 |
| Sex | |||||
| Female | 173 (45.8) | 56 (41.2) | 87 (45.1) | 128 (47.8) | .66 |
| Male | 205 (54.2) | 80 (58.8) | 106 (54.9) | 140 (52.2) | |
| Race | |||||
| American Indian or Alaska Native | 8 (2.4) | 1 (0.8) | 2 (1.1) | 5 (2.1) | .47 |
| Asian or Pacific Islander | 22 (6.7) | 7 (5.9) | 9 (5.1) | 5 (2.1) | |
| Black | 44 (13.3) | 21 (17.6) | 24 (13.7) | 37 (15.7) | |
| White | 250 (75.8) | 89 (74.8) | 134 (76.6) | 183 (77.9) | |
| More than 1 race | 6 (1.8) | 1 (0.8) | 6 (3.4) | 5 (2.1) | |
| Missing | 48 | 17 | 18 | 33 | |
| Ethnicity | |||||
| Hispanic or Latino | 68 (20.5) | 9 (7.8) | 42 (24.3) | 40 (16.5) | .003 |
| non–Hispanic or Latino | 263 (79.5) | 106 (92.2) | 131 (75.7) | 203 (83.5) | |
| Missing | 47 | 21 | 20 | 25 | |
| Admit category | |||||
| Shock/infection/trauma | 129 (34.1) | 79 (58.1) | 50 (25.9) | 106 (39.6) | <.001 |
| Respiratory failure | 70 (18.5) | 17 (12.5) | 46 (23.8) | 61 (22.8) | |
| Postsurgical/minor trauma | 16 (4.2) | 8 (5.9) | 6 (3.1) | 19 (7.1) | |
| CNS dysfunction | 21 (5.6) | 4 (2.9) | 9 (4.7) | 5 (1.9) | |
| Pain/sedation | 2 (0.5) | 1 (0.7) | 2 (1.0) | 3 (1.1) | |
| Primary cardiac disease | 3 (0.8) | 1 (0.7) | 8 (4.1) | 18 (6.7) | |
| Post cardiac surgery | 11 (2.9) | 3 (2.2) | 10 (5.2) | 23 (8.6) | |
| Heart failure/myopathy | 16 (4.2) | 2 (1.5) | 16 (8.3) | 5 (1.9) | |
| Other | 110 (29.1) | 21 (15.4) | 46 (23.8) | 28 (10.4) | |
| Comorbidity | |||||
| None | 87 (23.0) | 31 (22.8) | 28 (14.5) | 45 (16.8) | .04 |
| Respiratory | 39 (10.3) | 16 (11.8) | 28 (14.5) | 48 (17.9) | .04 |
| Cardiac | 42 (11.1) | 18 (13.2) | 51 (26.4) | 79 (29.5) | <.001 |
| Neurologic/neuromuscular | 39 (10.3) | 27 (19.9) | 25 (13.0) | 40 (14.9) | .03 |
| Nephrologic/urologic | 38 (10.1) | 12 (8.8) | 20 (10.4) | 19 (7.1) | .55 |
| Hematologic | 52 (13.8) | 21 (15.4) | 32 (16.6) | 27 (10.1) | .19 |
| Oncologic | 91 (24.1) | 30 (22.1) | 50 (25.9) | 50 (18.7) | .25 |
| Immunologic | 67 (17.7) | 20 (14.7) | 31 (16.1) | 35 (13.1) | .44 |
| Gastrointestinal | 67 (17.7) | 25 (18.4) | 30 (15.5) | 62 (23.2) | .18 |
| Endocrinologic | 17 (4.5) | 14 (10.3) | 14 (7.3) | 17 (6.3) | .11 |
| Comorbidities, No. | |||||
| 0 | 87 (23.0) | 31 (22.8) | 28 (15.5) | 45 (16.8) | .03 |
| 1 | 183 (48.4) | 63 (46.3) | 100 (51.8) | 132 (49.3) | |
| 2 | 80 (21.2) | 24 (17.6) | 36 (18.7) | 51 (19.0) | |
| >2 | 28 (7.4) | 18 (13.2) | 29 (15.0) | 40 (14.9) | |
| Baseline measured serum creatinine, median (IQR), mg/dL | 0.5 (0.3-0.7) [n = 189] | 0.3 (0.2-0.7) [n = 65] | 0.5 (0.3-0.7) [n = 116] | 0.3 (0.2-0.5) [n = 116] | <.001 |
| Sepsis at ICU admission | 146 (38.6) | 82 (60.3) | 83 (43.0) | 135 (50.4) | <.001 |
| PRISM-III score at ICU admission, median (IQR) | 14 (10-18) | 16 (12-21) | 12 (9-17) | 14 (9-18) | <.001 |
| PELOD-2 score at CRRT initiation, median (IQR) | 6 (3-9) | 8 (6-11) | 6 (4-8) | 7 (5-10) | <.001 |
| VIS score at CRRT initiation, median (IQR) | 0 (0-15) | 19 (9-39) | 3 (0-12) | 5 (0-17) | <.001 |
| VO at CRRT initiation, median (IQR), % | 2.64 (0.51-5.72) | 15.09 (12.07-24.61) | 3.78 (0.93-6.96) | 26.23 (16.57-41.58) | <.001 |
| Indexed UOP 24 h prior to CRRT initiation, median (IQR), mL/kg/h | 0.3 (0.16-0.9) | 0.4 (0.1-1.1) | 0.6 (0.2-1.3) | 0.7 (0.3-1.4) | <.001 |
| CRRT duration, d | 5 (2-12) | 7 (3-13) | 7 (3-16) | 7 (4-17) | <.001 |
| ICU mortality | 113 (30) | 51 (38) | 78 (40) | 107 (40) | .02 |
| 90-day mortality | 117 (31) | 56 (41) | 85 (44) | 108 (40) | .007 |
| MAKE-90 | 231 (62) | 83 (61) | 130 (67) | 182 (69) | .26 |
Abbreviations: CNS, central nervous system; CRRT, continuous renal replacement therapy; ICU, intensive care unit; MAKE-90, major adverse kidney events at 90 days (persistent kidney dysfunction, dialysis dependence, or death); PELOD-2, pediatric logistic organ dysfunction score; PRISM-III, pediatric risk of mortality score III; UOP, urine output; VIS, vasoactive inotrope score; VO, percentage volume overload.
SI conversion factor: To convert creatinine to μmol/L, multiply by 88.4.
There were 975 patients included in this analysis (5 excluded due to missing percentage VO). Categorical variables are presented as frequency with percentage.
Early CRRT defined as initiation less than or equal to 2 days after ICU admission.
Late CRRT defined as initiation greater than 2 days after ICU admission.
P values are calculated using χ2 test or Kruskal-Wallis test.