Supplementary Material for: Incidence and clinical outcomes of critically ill patients with augmented renal clearance: A retrospective cohort

Introduction: Although glomerular hyperfiltration in augmented renal clearance (ARC) results in suboptimal exposure to medications, its association with clinical outcomes is less clear. This study aimed to evaluate the incidence and clinical outcomes of ARC in an intensive care unit (ICU) population.
Methods: This retrospective cohort included all ICU patients admitted between July 1, 2018, and June 30, 2019. The primary outcome was the incidence of ARC, defined as a creatinine clearance  of 130 mL/min/1.73 m2, for at least one day. Secondary outcomes included mechanical ventilation (MV) duration, ICU length of stay (LOS), in-hospital and 30-day mortality, acute kidney injury (AKI), and development of a multidrug-resistant (MDR) pathogen.
Results: A total of 561 patients were included. The study population was 55% male (n=308), with a median age of 64 [IQR 53-74] years, a median baseline serum creatinine of 0.9 mg/dL [IQR 0.7-1.0], and primarily medical ICU population (n=396, 71%). The incidence of ARC was 25% (n=139). While there was no difference in MV duration, the ARC group had a longer ICU LOS (median [IQR] 6 [4-9] vs. 5 [4-8] days, p<0.001), and more MDR pathogens (22% vs. 9%, p<0.001). In-hospital mortality (6% vs. 12%, p=0.041), 30-day mortality (10% vs. 21%, p=0.005), and AKI (13% vs. 21%, p=0.027) were lower in patients with ARC.
Conclusion: The incidence of ARC in this general ICU population was 25%. Differences in the clinical outcomes of patients with ARC should be further investigated.

Introduction: 尽管增强型肾脏清除率（augmented renal clearance，ARC）中的肾小球高滤过（glomerular hyperfiltration）会导致药物暴露不足，但它与临床结局的关联尚不清楚。本研究旨在评估重症监护病房（intensive care unit，ICU）人群中ARC的发生率及临床结局。

Methods: 本回顾性队列研究纳入了2018年7月1日至2019年6月30日期间入院的所有ICU患者。主要结局为ARC的发生率，其定义为肌酐清除率（creatinine clearance）≥130 mL/min/1.73 m²且至少持续1天。次要结局包括机械通气（mechanical ventilation，MV）时长、ICU住院时间（length of stay，LOS）、住院期间及30天死亡率、急性肾损伤（acute kidney injury，AKI）以及多重耐药（multidrug-resistant，MDR）病原体的出现。

Results: 共纳入561例患者。研究人群中男性占55%（n=308），中位年龄为64[四分位距（interquartile range，IQR）53-74]岁，基线血清肌酐中位数为0.9 mg/dL[IQR 0.7-1.0]，且主要为内科ICU人群（n=396，71%）。ARC的发生率为25%（n=139）。尽管两组的MV时长无差异，但ARC组的ICU住院时间更长（中位数[IQR]：6[4-9]天 vs.5[4-8]天，p<0.001），且多重耐药病原体发生率更高（22% vs.9%，p<0.001）。ARC患者的住院死亡率（6% vs.12%，p=0.041）、30天死亡率（10% vs.21%，p=0.005）及AKI发生率（13% vs.21%，p=0.027）均较低。

Conclusion: 本普通ICU人群中ARC的发生率为25%。ARC患者临床结局的差异需进一步研究。