<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2312-3893</journal-id>
<journal-title><![CDATA[Revista Virtual de la Sociedad Paraguaya de Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. virtual Soc. Parag. Med. Int.]]></abbrev-journal-title>
<issn>2312-3893</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2312-38932025000100417</article-id>
<article-id pub-id-type="doi">10.18004/rvspmi/2312-3893/2025.e12142517</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Calcifilaxis con evolución fatal en paciente en hemodiálisis crónica]]></article-title>
<article-title xml:lang="en"><![CDATA[Calciphylaxis with fatal outcome in a patient undergoing chronic hemodialysis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montiel Alfonso]]></surname>
<given-names><![CDATA[Miguel Angel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bittar Duarte]]></surname>
<given-names><![CDATA[Carim Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Morínigo]]></surname>
<given-names><![CDATA[Elder]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giménez Duarte]]></surname>
<given-names><![CDATA[Evelyn Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Central del Instituto de Previsión Social Departamento de Medicina Interna Servicio de Clínica Médica I]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Católica Nuestra Señora de la Asunción Facultad de Ciencias de la Salud Dirección de Postgrado]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>417</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2312-38932025000100417&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2312-38932025000100417&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2312-38932025000100417&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La calcifilaxis es una complicación rara pero devastadora de la enfermedad renal crónica terminal (ERCT), especialmente en pacientes bajo tratamiento de hemodiálisis. Se caracteriza por calcificación de la capa media de las arterias, generando isquemia, necrosis y elevado riesgo de sepsis y muerte. Presentamos el caso de una mujer de 65 años con ERCT, secundaria a nefropatía hipertensiva, en hemodiálisis crónica, que desarrolló lesiones cutáneas necróticas extensas en miembros inferiores. Se documentaron alteraciones graves del metabolismo mineral óseo, incluyendo hiperparatiroidismo severo, hipercalcemia e hiperfosfatemia. El diagnóstico de calcifilaxis fue confirmado mediante biopsia. A pesar del tratamiento médico y quirúrgico planificado, la paciente presentó sobreinfección, trombosis de accesos vasculares, tromboembolismo pulmonar, sepsis y muerte por falla multiorgánica. Este caso ilustra la agresividad clínica de la calcifilaxis, su difícil manejo y la necesidad de una intervención precoz y multidisciplinaria.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Calciphylaxis is a rare but devastating complication of end-stage renal disease (ESRD), especially in patients undergoing hemodialysis. It is characterized by calcification of the middle layer of the arteries, leading to ischemia, necrosis, and an increased risk of sepsis and death. We present the case of a 65-year-old woman with ESRD secondary to hypertensive nephropathy, on chronic hemodialysis, who developed extensive necrotic skin lesions on her lower limbs. Severe alterations in bone mineral metabolism were documented, including severe hyperparathyroidism, hypercalcemia, and hyperphosphatemia. The diagnosis of calciphylaxis was confirmed by biopsy. Despite planned medical and surgical treatment, the patient developed superinfection, vascular access thrombosis, pulmonary thromboembolism, sepsis, and death from multiple organ failure. This case illustrates the clinical aggressiveness of calciphylaxis, its difficult management, and the need for early, multidisciplinary intervention.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[calcifilaxia]]></kwd>
<kwd lng="es"><![CDATA[enfermedad renal crónica]]></kwd>
<kwd lng="es"><![CDATA[hemodiálisis]]></kwd>
<kwd lng="es"><![CDATA[arteriopatías oclusivas]]></kwd>
<kwd lng="es"><![CDATA[hiperparatiroidismo]]></kwd>
<kwd lng="en"><![CDATA[calciphylaxis]]></kwd>
<kwd lng="en"><![CDATA[chronic kidney disease]]></kwd>
<kwd lng="en"><![CDATA[hemodialysis]]></kwd>
<kwd lng="en"><![CDATA[occlusive arterial disease]]></kwd>
<kwd lng="en"><![CDATA[hyperparathyroidism]]></kwd>
</kwd-group>
</article-meta>
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