Seacalphyx

Have been diagnosed with calciphylaxis either by:
a) 99m Technicium scintigraphy (bone scan) showing deposits that correspond to clinical lesions;
OR
b) Biopsy;
OR
c) Where scintigraphy negative and biopsy is not feasible, then diagnosis must be confirmed by nephrologist with submission of anonymized photographs of lesions AND a differential diagnosis checklist (e.g., warfarin-induced necrosis if on warfarin; lipohypertrophy if on insulin; cellulitis, nephrogenic sclerosing dermopathy, emboli, thrombi, fibrointimal hyperplasia and so on which depends on the site of lesion);

AND 

Patient has either:
a) Ulcerated lesions;
OR
b) Non-ulcerated lesions which have not improved after 2 weeks of multimodal treatment with replacement of calcium-containing phosphate binders with non- calcium containing binders (i.e. sevelamer), discontinuation of vitamin D analogs and initiation of calcimimetic (i.e., cinacalcet), changes in dialysis prescription (reduction in dialysate calcium; consideration of increased dialysis intensity), replacement of warfarin with alternative anticoagulants where possible, wound management strategies, and analgesia for lesion pain.