Abstract: This report describes a 60-year-old female patient with end stage renal disease (ESRD) who had received maintenance hemodialysis for over 17 years and developed the rare and severe complication of calciphylaxis combined with diabetic foot. She was admitted due to blackening and pain in her right third and fourth toes, with concurrent diagnoses of type 2 diabetes mellitus and atrial fibrillation. Following admission, she was diagnosed with calciphylaxis (based on characteristic skin lesions, systemic vascular calcification, and risk factors) and infected diabetic foot. Employing a multidisciplinary collaborative approach, the patient underwent 9 months of comprehensive intervention. Her foot ulcers healed completely; however, the right third and fourth toes underwent ischemic necrosis and autoamputation. This case highlights that for long-term dialysis patients with calciphylaxis and diabetic foot, early treatment with sodium thiosulfate (STS) combined with multidisciplinary management can effectively reduce amputation risk and improve prognosis. Nevertheless, distal limb ischemia remains a significant therapeutic challenge, warranting further exploration of optimized intervention strategies.

Key words: calciphylaxis, diabetic foot, maintenance hemodialysis, sodium thiosulfate, multidisciplinary collaboration