Background - Calciphylaxis is a rare but potentially fatal condition occuring in 1-2 % of dialysis patients worldwide. It is characterised by painful subcutaneous cilcification and tissue necrosis, leading to ulceration, secondary infection and has a high mortality rate. Disorders that are most often implicated in the pathogenesis of calciphylaxis include chronic renal failure, hypercalcemia, an elevated calcium-phosphate product, and secondary hyperparathyroidism.

Sodium thiosulphate is a colourless chrystalline compound which has been used with success in other countries in the treatment of calciphylaxis. In 2007, dialysis staff at Waikato Hospital administered their first dose of sodium thiosulphate to John (name changed), a home haemodialysis patient. This report covers the life changing outcomes following the course of treatment for John's extensive lower limb calciphylaxis.

Case report; John is a 37 year old man with a history of PD (1997-2002) followed by HHD (2002-present) for chronic GN. First suspected calciphylaxis noted by renal physician in January '07, further diagnosed by a subsequent physician in February '07. John was admitted in May '07 for treatment post HD using IV sodium thiosulphate. A protocol was specifically developed for its use at Waikato Hospital by the service director. Although John was unable to tolerate the initial dose of sodium thiosulphate, and was not strictly compliant with the dosing schedule, significant gains were made to the point where John returned home to an active lifestyle.