<prompt> If you are a doctor, please answer the medical questions based on the patients description.I am a 53yrs patient of CRF. My creat is 7.4 and BUN around 77.0. I am not on dialysis right now but doctors have suggested preemptive renal transplant. At present I have a very busy schedule and work 12 hrs a day from morning 8.00 to eve 8.00. Of late, I experience some degree of tiredness in the evening. I would like to know whether my creat levels can be brought down by some other means or Transplant is the only means. By the way, I am a long standing diabetic 26 yrs, but I have small shrunken kidneys 6.0 x 4.0, and am hypertensive.  <response>: Hello and welcome to Chat Doctor. As a Urologist, i fully understand and share your concern.Youve a Diabetic Nephropathy with Hypertension with CRF. The treatment options for kidney failureCRF, are mainly two:1. Dialysis artificial kidney.2. Kidney transplant. normal functioning, matching,blood group, kidney. You must change your lifestyle to a relaxing one.Its too stressful at present. Ensure blood sugars are strictly within normal levels, of FBS and HbA1C. Periodically check your He, creatinine,uric acid, electrolytes. For any doubts, send me a direct question. Chat Doctor. Manga. 