Don't know if this is more of a VDB issue rather a Houdini issue.
One thinks you should be able to create a relatively low resolution VDB for a large model, then combine it with VDB grids for areas of high detail. Good example, patching in a flip sims into a large body of water. You could have a relatively low rez SDF grid for the main body of water, then generate high rez SDFs for each of your flip simulations, do a VDB combine using 'min', and they all combine nicely.
As far as I can tell, the output is set to a single voxel size, multiresolution is not an option. I know that VDB scales so well, this should be a non-issue for most cases. But I'm definitely hitting RAM walls with the resolution detail requirements. Multires grids are a perfect solution to this problem.