Calciphylaxis Post‐Renal Transplantation: Two Cases and a Literature Review

Calciphylaxis is a rare yet life‐threatening syndrome characterized by vascular calcification and thrombosis, with poorly understood pathogenesis and limited therapeutic consensus, particularly in kidney transplant recipients. We report two cases of calciphylaxis following renal transplantation, diagnosed via a multidisciplinary approach integrating retrospective clinical data, laboratory analyses, imaging studies, and confirmatory histopathological examination of skin biopsies. A standardized treatment protocol centered on intravenous sodium thiosulfate, combined with aggressive wound care and optimization of calcium‐phosphate homeostasis, resulted in marked clinical improvement. Both patients exhibited resolution of necrotic skin lesions, stabilization of allograft function, and no recurrence during follow‐up. These outcomes underscore the importance of early diagnosis, confirmed by histopathology, and a multimodal therapeutic strategy targeting hyperparathyroidism, mineral dysregulation, and microvascular calcification. Our cases demonstrate that calciphylaxis may resolve with renal function recovery post‐transplant or sodium thiosulfate–based therapy, reinforcing its role in management and urging evidence‐based guidelines for this complication in transplant recipients.