Supplemental Table 1 Clinical Characteristics and Outcomes of Critically Ill Patients
Supplemental Table 1Clinical characteristics and outcomes of critically ill patients admitted in medical and surgical intensive care unit (ICU) during study period
Characteristics / Medical ICU(n=3722) / Surgical ICU
(n=3974)
Age, year, median (IQR) / 65 (53-77) / 66 (53-76)
Male sex, n (%) / 2050 (55) / 2434 (61)
White, n (%) / 3495 (94) / 3719 (94)
Body weight, kg, median (IQR) / 82 (68-98) / 84 (70-97)
Baseline creatinine, mg/dL, median (IQR) / 0.9 (0.7-1.2) / 0.9 (0.8-1.1)
Comorbidities, n (%)
-Diabetes mellitus
-Hypertension
-Coronary artery disease
-Congestive heart failure
-Chronic obstructive pulmonary disease
-Cirrhosis
-Chronic kidney disease* / 980 (26)
2133 (57)
967 (26)
517 (14)
261 (7)
261 (7)
1079 (29) / 836 (21)
2316 (58)
1092 (27)
365 (9)
490 (12)
86 (2)
971 (24)
Nephrotoxic medication, n (%)
-NSAIDs
-Gentamicin
-Amphotericin
-Calcineurin inhibitor / 216 (6)
27 (0.7)
36 (1)
78 (2) / 651 (16)
19 (0.5)
8 (0.2)
35 (1)
APACHE III score, median (IQR) / 44 (31-59) / 47 (35-60)
SOFA score, median (IQR) / 4 (2-6) / 5 (3-7)
Septic shock / 1021 (27) / 494 (12)
Fluid balance in ICU, liter, mean±SD / 1.8±6.1 / 2.8±4.4
ICU length of stay, day, median (IQR) / 1.4 (0.9-2.6) / 1.2 (0.9-2.4)
ICU mortality, n (%) / 160 (4) / 70 (2)
60-day mortality, n (%) / 544 (15) / 193 (5)
*Chronic kidney disease was defined by K/DOQI CKD stage III or worse (estimated glomerular filtration rate < 60 ml/min/1.73 m2 according to CKD-EPI formula)
Abbreviations: APACHE, Acute Physiology and Chronic Health Evaluation; SOFA, Sequential Organ Failure Assessment; IQR, interquartile range; ICU, intensive care unit
Supplemental Table 2.The effect of serum creatinine (SCr) adjustment for fluid balance on acute kidney injury (AKI)diagnosis and the risk for 60-day mortality in a) medical intensive care unit (ICU) and b) surgical intensive care unit (ICU)
a)Medical intensive care unit (ICU)(n=3722)
Fluid adjustment / No fluid adjustment / N / 60-daymortality rate / Adjusted OR (95% CI)*AKI / AKI / 1017 / 28.1% / 2.69 (2.19-3.30)
AKI / No AKI / 72 / 23.6% / 2.25 (1.21-3.99)
No AKI / AKI / 64 / 9.4% / 1.04 (0.39-2.32)
No AKI / No AKI / 2569 / 9.2% / Reference group
AKI; 29.0% before adjustment vs 29.3% after adjustment (P=.49)
* OR is adjusted for age, APACHE score, and fluid balance in ICU.
b) Surgical intensive care unit (ICU)(n=3974)
Fluid adjustment / No fluid adjustment / N / 60-daymortality rate / Adjusted OR (95% CI)*AKI / AKI / 756 / 15.0% / 5.73 (4.14-7.99)
AKI / No AKI / 102 / 10.8% / 3.13 (1.48-6.09)
No AKI / AKI / 23 / 4.4% / 2.08 (0.11-10.67)
No AKI / No AKI / 3093 / 2.2% / Reference group
AKI; 19.6% before adjustment vs 21.6% after adjustment (P<.001)
* OR is adjusted for age, APACHE score, and fluid balance in ICU
Abbreviations: AKI, acute kidney injury; APACHE, acute physiology and chronic health evaluation; CI, confidence interval; OR, odds ratio;
Supplemental Table 3. The effect of serum creatinine(SCr) adjustment for acute kidney injury (AKI) diagnosis in different tertiles of total fluid balance in intensive care unit (ICU)
a)Tertile 1: fluid balance (range -11.6 L to +0.5L)
AKI(no fluid adjustment) / AKI (fluid adjustment) / N (%)
Yes / No
Yes / 455 (17.7) / 86 (3.4) / 541(21.1)
No / 4 (0.2) / 2020 (78.8) / 2024 (78.9)
N (%) / 459 (17.9) / 2106 (82.1) / 2565
b)Tertile 2: fluid balance (range +0.5L to +2.9L)
AKI(no fluid adjustment) / AKI (fluid adjustment) / Total
N (5)
Yes / No
Yes / 468 (18.3) / 1 (0.04) / 469 (18.3)
No / 20 (0.8) / 2076 (80.9) / 2096 (81.7)
Total, N (%) / 488 (19.0) / 2077 (81.0) / 2565
c)Tertile 3: fluid balance (range +2.9 L to +36.6L)
AKI(no fluid adjustment) / AKI (fluid adjustment) / Total
N (5)
Yes / No
Yes / 850 (33.1) / 0 (0) / 850 (33.1)
No / 150 (5.9) / 1566 (61.0) / 1716 (66.9)
Total, N (%) / 1000 (39.0) / 1566 (61.0) / 2566
Abbreviations: AKI, acute kidney injury