Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

Miyamoto, Yoshihisa; Iwagami, Masao; Aso, Shotaro; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Hamasaki, Yoshifumi; Nangaku, Masaomi; Doi, Kent

doi:10.1186/s13054-019-2468-8

Critical Care

Table 3 Subgroup analyses: adjusted odds ratio for in-hospital mortality by renal replacement therapy modality and by main diagnosis category

From: Temporal change in characteristics and outcomes of acute kidney injury on renal replacement therapy in intensive care units: analysis of a nationwide administrative database in Japan, 2007–2016

	Year
	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016
Subgroup by RRT modality^a
(i) Patients starting CRRT	1 (ref.)	0.99 (0.89,1.10)	0.97 (0.87,1.09)	0.90 (0.81,1.00)	0.85 (0.77,0.95)	0.80 (0.73,0.89)	0.74 (0.67,0.82)	0.76 (0.69,0.85)	0.73 (0.66,0.80)	0.67 (0.61,0.75)
(ii) Patients starting IRRT	1 (ref.)	0.74 (0.56,0.97)	0.96 (0.23,1.27)	0.79 (0.61,1.02)	0.73 (0.57,0.93)	0.75 (0.59,0.95)	0.70 (0.55,0.89)	0.72 (0.57,0.91)	0.70 (0.55,0.89)	0.58 (0.45,0.74)
Subgroup by main diagnosis category^b
(i) Sepsis	1 (ref.)	1.00 (0.82,1.20)	1.09 (0.89,1.32)	0.93 (0.78,1.12)	0.87 (0.73,1.04)	0.85 (0.71,1.02)	0.69 (0.58,0.83)	0.77 (0.65,0.92)	0.74 (0.62,0.87)	0.68 (0.57,0.81)
(ii) Cardiovascular surgery	1 (ref.)	0.82 (0.63,1.09)	0.85 (0.64,1.12)	0.90 (0.69,1.17)	0.82 (0.64,1.07)	0.77 (0.59,0.99)	0.79 (0.61,1.02)	0.74 (0.58,0.96)	0.73 (0.57,0.93)	0.58 (0.45,0.76)
(iii) Coronary artery disease	1 (ref.)	0.95 (0.67,1.35)	0.82 (0.57,1.19)	0.81 (0.57,1.15)	0.92 (0.65,1.30)	0.71 (0.50,1.00)	0.73 (0.52,1.03)	0.85 (0.60,1.19)	0.83 (0.59,1.16)	0.84 (0.60,1.19)
(iv) Non-coronary heart disease	1 (ref.)	1.11 (0.91,1.35)	1.14 (0.93,1.40)	0.93 (0.77,1.13)	0.90 (0.75,1.10)	0.87 (0.72,1.05)	0.83 (0.69,1.00)	0.84 (0.69,1.01)	0.86 (0.71,1.03)	0.78 (0.64,0.94)
(v) CNS disorders	1 (ref.)	0.76 (0.50,1.13)	0.98 (0.64,1.50)	0.64 (0.43,0.96)	0.52 (0.35,0.77)	0.54 (0.36,0.79)	0.58 (0.40,0.86)	0.41 (0.28,0.61)	0.45 (0.31,0.67)	0.42 (0.28,0.62)
(vi) Trauma	1 (ref.)	0.72 (0.36,1.46)	0.62 (0.30,1.29)	0.73 (0.39,1.39)	0.52 (0.28,0.97)	0.58 (0.32,1.07)	0.61 (0.33,1.12)	0.52 (0.29,0.95)	0.41 (0.22,0.76)	0.39 (0.21,0.72)
(vii) Other	1 (ref.)	0.97 (0.74,1.25)	0.85 (0.65,1.12)	0.98 (0.76,1.26)	0.90 (0.76,1.26)	0.88 (0.69,1.13)	0.76 (0.59,0.97)	0.89 (0.70,1.14)	0.70 (0.55,0.90)	0.64 (0.50,0.82)
Subgroup by age (years)^c
(i) < 65	1 (ref.)	1.17 (0.90, 1.28)	1.04 (0.86, 1.25)	0.91 (0.77, 1.08)	0.85 (0.72, 1.00)	0.82 (0.70, 0.98)	0.79 (0.67, 0.94)	0.79 (0.67, 0.94)	0.83 (0.70, 0.98)	0.68 (0.57, 0.80)
(ii) 65–74	1 (ref.)	0.90 (0.75, 1.09)	1.05 (0.86, 1.27)	0.94 (0.79, 1.12)	0.87 (0.73, 1.04)	0.86 (0.72, 1.02)	0.66 (0.55, 0.78)	0.78 (0.66, 0.93)	0.70 (0.59, 0.83)	0.68 (0.57, 0.81)
(iii) 74–85	1 (ref.)	0.89 (0.74, 1.06)	0.86 (0.71, 1.04)	0.84 (0.70, 1.00)	0.74 (0.63, 0.88)	0.75 (0.64, 0.89)	0.73 (0.62, 0.86)	0.70 (0.59, 0.82)	0.63 (0.53, 0.74)	0.61 (0.52, 0.72)
(iv) > 85	1 (ref.)	1.01 (0.70, 1.48)	0.89 (0.62, 1.28)	0.79 (0.55, 1.12)	1.02 (0.72, 1.44)	0.70 (0.50, 0.98)	0.79 (0.56, 1.11)	0.80 (0.57, 1.10)	0.76 (0.55, 1.05)	0.63 (0.45, 0.87)
Subgroup by sex^d
(i) Male	1 (ref.)	0.95 (0.84, 1.08)	0.99 (0.87, 1.13)	0.89 (0.79, 1.00)	0.86 (0.76, 0.97)	0.81 (0.72, 0.91)	0.76 (0.67, 0.85)	0.76 (0.68, 0.86)	0.73 (0.65, 0.82)	0.66 (0.59, 0.75)
(ii) Female	1 (ref.)	0.96 (0.82, 1.14)	0.94 (0.79, 1.12)	0.90 (0.77, 1.06)	0.80 (0.69, 0.94)	0.77 (0.66, 0.89)	0.70 (0.60, 0.82)	0.74 (0.64, 0.87)	0.71 (0.61, 0.83)	0.65 (0.55, 0.76)
Subgroup by CKD^e
(i) With CKD	1 (ref.)	0.91 (0.73, 1.13)	0.96 (0.76, 1.21)	0.75 (0.60, 0.93)	0.76 (0.61, 0.94)	0.77 (0.62, 0.94)	0.73 (0.59, 0.90)	0.71 (0.57, 0.87)	0.70 (0.57, 0.86)	0.63 (0.51, 0.78)
(ii) Without CKD	1 (ref.)	0.97 (0.87, 1.09)	0.97 (0.87, 1.10)	0.93 (0.84, 1.04)	0.86 (0.77, 0.96)	0.81 (0.73, 0.90)	0.74 (0.67, 0.83)	0.77 (0.70, 0.86)	0.74 (0.66, 0.82)	0.67 (0.60, 0.74)
Subgroup by mechanical ventilation^f
(i) Receiving mechanical ventilation at RRT start	1 (ref.)	0.92 (0.81, 1.06)	0.93 (0.81, 1.07)	0.91 (0.80, 1.03)	0.79 (0.69, 0.89)	0.75 (0.66, 0.85)	0.66 (0.58, 0.75)	0.72 (0.64, 0.82)	0.69 (0.61, 0.78)	0.65 (0.57, 0.74)
(ii) Not receiving mechanical ventilation at RRT start	1 (ref.)	0.99 (0.85, 1.15)	1.01 (0.86, 1.18)	0.84 (0.72, 0.97)	0.89 (0.76, 1.02)	0.85 (0.74, 0.98)	0.84 (0.73, 0.97)	0.80 (0.70, 0.92)	0.75 (0.65, 0.86)	0.65 (0.56, 0.75)

CKD chronic kidney disease, CI confidence interval, CNS central nervous system, CRRT continuous renal replacement therapy, IRRT intermittent renal replacement therapy, RRT renal replacement therapy
^aAdjusted for the covariates used in the main analysis (see Table 2) except for RRT modality
^bAdjusted for the covariates used in the main analysis (see Table 2) except for the main diagnosis category
^cAdjusted for covariates used in the main analysis (see Table 2) except for age category
^dAdjusted for covariates used in the main analysis (see Table 2) except for sex
^eAdjusted for covariates used in the main analysis (see Table 2) except for CKD
^fAdjusted for covariates used in the main analysis (see Table 2) except for mechanical ventilation

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