Resumo

MONTIEL ALFONSO, Miguel Angel; BITTAR DUARTE, Carim Pedro; GARCIA MORINIGO, Elder  e  GIMENEZ DUARTE, Evelyn Raquel. Calciphylaxis with fatal outcome in a patient undergoing chronic hemodialysis. Rev. virtual Soc. Parag. Med. Int. [online]. 2025, vol.12, n.1, e12142517.  Epub 23-Ago-2025. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2025.e12142517.

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.

Palavras-chave : calciphylaxis; chronic kidney disease; hemodialysis; occlusive arterial disease; hyperparathyroidism.

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