Supplementary Method 1. Diagnostic codes for the definition of major adverse cardiovascular event and related cerebro- or cardiovascular disease.
Major adverse cardiovascular event (MACE) was defined when one of the following disease was present; acute myocardial infarction, defined by ICD-10 diagnostic code I21 or I22 was issued during admission; Revascularization, defined by claim history of cardiovascular revascularization procedure; and acute ischemic stroke, defined by ICD-10 diagnostic code I63 was issued during admission.
Known MACE related cerebro/cardiovascular disease was identified using the following ICD-10 diagnostic codes; I20, I21, I22, I23, I24, I25, I60, I61, I62, I63, I64, I65, I66, I670, I671, I672, I675, I676, I677, I678, I679, I681, I682, I688, I69, G450, G451, G452, G458, G459, G46, G454.
Supplementary Method 2. Detailed information regarding the propensity-score-based matching process and the adjusted variables for the multivariable analysis.
Model 1 was an unadjusted simple model.
Model 2 was adjusted for age, sex, the Charlson comorbidity index scores, and usage of
mechanical ventilation, and intravenous inotropic agents, and the principal diagnosis during the index admission (categorical, the most common five alphabetical ICD-10 diagnostic codes (A, C, I, J, K, N), and others)
Model 3 was a multivariable Cox regression analysis performed in the 1:1 propensity score
matched dataset. The propensity scores were calculated with patients’ age, sex, presence of each comorbidities in the Charlson comorbidity index, and principal diagnosis during index admission (the alphabetical ICD-10 diagnostic codes). When the matching was performed between the study and the control group, all patients within the study group were 1:1 matched to the patients in the control group. Still, regarding matching between the CRRT and the IRRT group, 4,789 patients in the CRRT group were matched to the same number of patients in the IRRT group and 2,102 CRRT patients were not included in the matched analysis due to the significant difference in baseline variables which made them impossible to find an appropriate matched IRRT patients.
Between the matched patients, there was no significant difference in variables included in the matching process. The multivariable analysis was adjusted for all variables included in the model 2.
Supplementary Table 1. Underlying comorbidities and main diagnosis of the study population.
Control group (N=382,018)
ARRT group (N=12,380)
P value
Underlying comorbidities (CCI)
Hypertension 162,540(42.6) 7,163(57.9) <0.001
Diabetes 71,717(18.8) 4,056(32.8) <0.001
Diabetic complication 14,358(3.8) 1,508(12.2) <0.001
Connective tissue disease 7,960(2.1) 356(2.9) <0.001
Congestive heart failure 15,670(4.1) 738(6.0) <0.001
Peripheral vascular disease 22,206(5.8) 715(5.8) 0.861
Dementia 6,774(1.8) 303(2.5) <0.001
Pulmonary disease 82,618(21.6) 2,301(18.6) <0.001
Peptic ulcer 79,313(20.8) 2,617(21.1) 0.308
Liver disease 19,967(5.2) 536(4.3) <0.001
Severe liver disease 3,807(1.0) 425(3.4) <0.001
Paraplegia 1,124(0.3) 30(0.2) 0.293
Renal Disease 4,696(1.2) 2,170(17.5) <0.001
Cancer 107,764(28.2) 2,025(16.4) <0.001
Metastatic cancer 17,500(4.6) 432(3.5) <0.001
Human immunodeficiency virus 158(0.0) 6(0.01) 0.703
Principal diagnosis, ICD-10 alphabetical
index < 0.001
Certain infectious and parasitic diseases A 8,135(2.1) 715(5.8)
B 2,053(0.5) 193(1.6)
Neoplasms or hematological diseases C 121,692(31.9) 1,881(15.2)
D 29,257(7.7) 205(1.7)
Endocrine nutritional and metabolic diseases E 4,403(1.2) 337(2.7)
Mental and behavioral diseases F 2,250(0.6) 67(0.5)
Diseases of the nervous system G 14,798(3.9) 110(0.9)
Diseases of the ear and mastoid process H 246(0.1) 3(0.0) Diseases of the circulatory system I 57,969(15.2) 1,209(9.8) Diseases of the respiratory system J 18,524(4.9) 575(4.6) Diseases of the digestive system K 36,977(9.7) 1,286(10.4) Diseases of the skin and subcutaneous tissue L 679(0.2) 26(0.2) Diseases of the muscle and connective tissue M 12,553(3.3) 295(2.4) Diseases of the genitourinary system N 5,074(1.3) 3,113(25.2)
Pregnancy related status O 3,034(0.8) 65(0.5)
P 2(0.0) 0(0.0)
Congenital diseases Q 6,086(1.6) 43(0.4)
Abnormal clinical and laboratory findings not
elsewhere classified R 4,079(1.1) 152(1.2)
Injury poisoning and other consequences of
external causes S 36,901(9.7) 283(2.3)
T 13,912(3.6) 1,281(10.4)
Factors influencing health status and contact
with health services Z 3,275(0.9) 540(4.4)
Unspecified U 119(0.0) 1(0.0)
ARRT = acute renal replacement therapy, CCI = Charson comorbidity index, ICD = international classification of diseases
Supplementary Table 2. Baseline characteristics of the IRRT and the CRRT group.
IRRT group
(N=5,034) CRRT group
(N=6,891) P value
Age (years) 55(43-69) 57(46-70) <0.001
< 40 975(19.4) 1,063(15.4)
≥ 40 and < 60 1,961(39.0) 2,680(38.9)
≥ 60 and < 80 1,758(34.9) 2,711(39.3)
≥ 80 340(6.8) 437(6.3)
Male sex (N, %) 2,968(59.0) 4,106(59.6) 0.017
Era of admission (N, %) <0.001
2015~ 1,449(28.8) 1,494(21.7)
2010~2014 2,325(46.2) 3,480(50.5)
2005~2009 1,260(25.0) 1,917(27.8)
CCI score 2 (0-4) 2 (0-4) <0.001
≥ 0 and< 5 4,494(89.3) 6,080(88.2)
≥ 5 and < 10 530(10.5) 765(11.1)
≥ 10 10(0.2) 46(0.7)
Implemented treatment during ICU admission
Ventilator care 1,428(28.4) 4,633(67.2) <0.001
Intravenous inotropic agents 2,083(41.4) 5,563(80.7) <0.001
Cardiac operation 41(0.8) 311(4.5) <0.001
Underlying comorbidities (CCI)
Hypertension 2,969(59.0) 3,934(57.1) 0.039
Diabetes 1,617(32.1) 2,287(33.2) 0.220
Diabetic complication 715(14.2) 728(10.6) <0.001
Connective tissue disease 126(2.5) 219(3.2) 0.030
Congestive heart failure 254(5.1) 453(6.6) <0.001
Peripheral vascular disease 286(5.7) 412(6.0) 0.494
Dementia 104(2.1) 190(2.8) 0.016
Pulmonary disease 823(16.4) 1,391(20.2) <0.001
Peptic ulcer 933(18.5) 1,600(23.2) <0.001
Liver disease 124(2.5) 387(5.6) <0.001
Severe liver disease 84(1.7) 328(4.8) <0.001
Paraplegia 8(0.2) 18(0.3) 0.237
Renal Disease 1,409(28.0) 696(10.1) <0.001
Cancer 224(4.5) 191(2.8) <0.001
Metastatic cancer 84(1.7) 328(4.8) <0.001
Human immunodeficiency virus 0(0.0) 5(0.1) 0.056
Principal diagnosis, ICD-10 alphabetical index < 0.001
Certain infectious and parasitic diseases A 138(2.7) 544(7.9)
B 71(1.4) 119(1.7)
Neoplasms or hematological diseases C 706(14.0) 1,116(16.2)
D 77(1.5) 122(1.8)
Endocrine nutritional and metabolic diseases E 103(2.1) 200(2.9)
Mental and behavioral diseases F 19(0.4) 46(0.7)
Diseases of the nervous system G 38(0.8) 68(1.0)
Diseases of the ear and mastoid process H 1(0.0) 1(0.0)
Diseases of the circulatory system I 297(5.9) 863(12.5)
Diseases of the respiratory system J 161(3.2) 391(5.7)
Diseases of the digestive system K 258(5.1) 982(14.3)
Diseases of the skin and subcutaneous tissue L 7(0.1) 18(0.3) Diseases of the muscle and connective tissue M 87(1.7) 202(2.9)
Diseases of the genitourinary system N 1,668(33.1) 1,321(19.2)
Pregnancy related status O 13(0.3) 48(0.7)
P 0(0.0) 0(0.0)
Congenital diseases Q 14(0.3) 29(0.4)
Abnormal clinical and laboratory findings not
elsewhere classified R 22(0.4) 122(1.8)
Injury poisoning and other consequences of external causes
S 101(2.0) 170(2.5)
T 932(18.5) 317(4.6)
Factors influencing health status and contact with
health services Z 138(2.7) 544(7.9)
Unspecified U 0(0.0) 1(0.0)
IRRT = intermittent renal replacement therapy, CRRT = continuous renal replacement therapy, CCI = Charson comorbidity index, ICD = international classification of diseases
Supplementary Table 3. Clinical characteristics associated with MACE in the ARRT group
Multiple cox regression Backward elimination
Age (years) 1.0401.034-
1.045) <0.00
1 1.042(1.037-
1.047) <0.00
Male sex (N, %) 1.195(1.043- 1
1.370) 0.011 1.184(1.035-
1.355) 0.014
Underlying comorbidities (CCI)
Hypertension 1.083(0.911-
1.286) 0.365
Diabetes 1.245(1.057-
1.465) 0.009 1.269(1.082-
1.488) 0.003
Diabetic complication 1.627(1.348-
1.965) <0.00
1 1.638(1.357-
1.977) <0.00
Connective tissue disease 1.118(0.766- 1
1.63) 0.564
Congestive heart failure 1.325(1.061-
1.654) 0.013 1.335(1.073-
1.661) 0.009
Peripheral vascular disease 1.093(0.862-
1.386) 0.463 2.449(1.011-
5.935) 0.047
Dementia 1.252(0.883-
1.774) 0.208
Pulmonary disease 1.068(0.911-
1.251) 0.417
Peptic ulcer 1.093(0.937-
1.275) 0.259
Liver disease 0.908(0.564-
1.461) 0.064
Severe liver disease 0.589(0.337-
1.027) 0.062
Paraplegia 2.425(0.998-
5.889) 0.050
Renal Disease 1.325(1.118-
1.572) 0.001 1.354(1.148-
1.596) <0.00
Cancer 1.014(0.760- 1
1.352) 0.925
Metastatic cancer 0.749(0.399-
1.404) 0.367
Human immunodeficiency virus 7.003(0.896-
54.717) 0.691
Principal diagnosis, ICD-10 alphabetical index
Certain infectious and parasitic diseases A 1.03(0.683-
1.553) 0.887 1.078(0.754-
1.541) 0.680
B 0.416(0.143-
1.213) 0.108 0.486(0.177-
1.330) 0.160
Neoplasms or hematological diseases C Reference Reference
D 1.075(0.555-
2.084) 0.830 1.141(0.606-
2.145) 0.683
Endocrine nutritional and metabolic diseases E 1.505(0.949-
2.387) 0.082 1.590(1.055-
2.396) 0.027
Mental and behavioral diseases F 0.988(0.307-
3.181) 0.985 1.04(0.328-
3.298) 0.947
Diseases of the nervous system G 2.961(1.609-
5.451) 0.001 3.116(1.760-
5.519) <0.00
Diseases of the ear and mastoid process H NA 1
Diseases of the circulatory system I 1.739(1.213-
2.493) 0.003 1.822(1.379-
2.409) <0.00
Diseases of the respiratory system J 1.499(1.008- 1
2.228) 0.045 1.638(1.171-
2.291) 0.004
Diseases of the digestive system K 0.972(0.664-
1.424) 0.886 0.964(0.697-
1.334) 0.827
Diseases of the skin and subcutaneous tissue L 0.469(0.064-
3.425) 0.456 0.505(0.070-
3.638) 0.498
Diseases of the muscle and connective tissue M 1.91(1.2-3.041) 0.006 2.048(1.349-
3.108) 0.001
Diseases of the genitourinary system N 1.292(0.932-
1.791) 0.124 1.382(1.072-
1.782) 0.013
Pregnancy related status O NA
P NA
Congenital diseases Q 0.351(0.048-
2.558) 0.302 0.355(0.049-
2.551) 0.303
Abnormal clinical and laboratory findings not
elsewhere classified R 1.113(0.522-
2.372) 0.782 1.178(0.569-
2.442) 0.659
Injury poisoning and other consequences of external causes
S 1.485(0.902-
2.445) 0.120 1.591(1.014-
2.496) 0.043
T 0.975(0.647-
1.469) 0.903 1.062(0.747-
1.510) 0.738
Factors influencing health status and contact with
health services Z 0.392(0.19-
0.807) 0.011 0.390(0.195-
0.783) 0.008
Unspecified U NA
Implemented treatment modalities
Ventilator care 1.114(0.951-
1.305) 0.180
Intravenous inotropic agents 0.873(0.745-
1.023) 0.093
Cardiac_operation 0.915(0.637-
1.312) 0.628
Supplementary Figure 1. Survival curves of the patient mortality and progression to ESRD outcomes.
The Kaplan-Meier survival curves of the patient mortality and progression to ESRD. The x-axes indicate the time (years), and the y-axes indicate the incidence probability. The black, red, blue, and green lines indicate the survival curves of the control, acute renal replacement therapy, intermittent renal replacement therapy, and continuous renal replacement therapy groups, respectively. The tables including the numbers at risk are shown below each of the survival graphs.
