Abstract
Calcific uremic arteriolopathy (calciphylaxis) is a rare, painful condition in ESRD patients causing skin lesions and tissue ischemia. While typically affecting proximal areas, distal sites, including the penis, can also be involved. We present a 55-year-old male with ESRD who developed calciphylaxis in the fingers, toes, and penis months after a kidney transplant. Despite treatment with sodium thiosulfate and hemodialysis, his condition worsened, requiring toe amputation and management of recurrent infections. This case highlights the severity of calciphylaxis, especially post-transplant, and the need for prompt diagnosis and aggressive management.