Tropical medicine & international health : TM & IH · 2026
Incidence and Severe Outcomes of Acute Kidney Injury in Haff Disease: A Brazilian Cohort Study.
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Domingues-da-Silva Raoni de Oliveira, Oliveira Haicha Brarymi, Teixeira Thiago Afonso, Lopes Gisele Rocha, Chagas Gabriel Cavalcante Lima, Santiago Alefe Islleyker Aguiar, de Almeida Mota Ramalho Janaína, Meneses Gdayllon Cavalcante, Israel Karla Cristina Petruccelli, Santos Paula Bruna Sousa, da Conceição Andrade Lúcia, Junior Geraldo Bezerra Silva, Martins Alice Maria Costa, Daher Elizabeth De Francesco
Аннотация
INTRODUCTION: Haff disease, characterised by rhabdomyolysis within 24 h of fish ingestion, is a rare but potentially severe condition. Acute Kidney Injury (AKI) is recognised as a significant complication, yet effective prognosis assessment is difficult due to clinical variability and the disease's low incidence. This study aimed to determine the incidence and severity of AKI in Haff disease patients from a recent outbreak, comparing clinical and laboratory features between those with and without this complication.
METHODS: This retrospective cohort study utilised medical records from a Brazilian tertiary hospital between 2021 and 2022. Adult patients presenting within 24 h of fish consumption with serum Creatine Phosphokinase (CPK) levels at least five times the upper reference limit and classic signs of rhabdomyolysis were included.
RESULTS: Eighteen patients met inclusion criteria, 56% male, mean age 52.6 ± 16.4 years, 28% with diabetes, 39% with hypertension. No patient died in our cohort. AKI occurred in 8 patients (44%), predominantly classified as KDIGO stage 3 (75%). Within the AKI group, 2 (25%) presented with oliguria, 5 (63%) required dialysis and 3 (38%) remained dialysis-dependent at discharge. Both patients requiring intensive care unit admission belonged to the AKI group. Peak levels of liver enzymes (AST p = 0.005, ALT p = 0.018), Lactate Dehydrogenase (p = 0.042) and both admission (p = 0.008) and peak (p = 0.003) CK-MB were significantly higher in patients who developed AKI.
CONCLUSION: AKI incidence in this Haff disease cohort was notably high. The AKI group had a more severe clinical trajectory, encompassing all ICU admissions and frequent dialysis requirements, with a concerning rate of persistent dialysis dependence at discharge.
METHODS: This retrospective cohort study utilised medical records from a Brazilian tertiary hospital between 2021 and 2022. Adult patients presenting within 24 h of fish consumption with serum Creatine Phosphokinase (CPK) levels at least five times the upper reference limit and classic signs of rhabdomyolysis were included.
RESULTS: Eighteen patients met inclusion criteria, 56% male, mean age 52.6 ± 16.4 years, 28% with diabetes, 39% with hypertension. No patient died in our cohort. AKI occurred in 8 patients (44%), predominantly classified as KDIGO stage 3 (75%). Within the AKI group, 2 (25%) presented with oliguria, 5 (63%) required dialysis and 3 (38%) remained dialysis-dependent at discharge. Both patients requiring intensive care unit admission belonged to the AKI group. Peak levels of liver enzymes (AST p = 0.005, ALT p = 0.018), Lactate Dehydrogenase (p = 0.042) and both admission (p = 0.008) and peak (p = 0.003) CK-MB were significantly higher in patients who developed AKI.
CONCLUSION: AKI incidence in this Haff disease cohort was notably high. The AKI group had a more severe clinical trajectory, encompassing all ICU admissions and frequent dialysis requirements, with a concerning rate of persistent dialysis dependence at discharge.