Hello doctor, I want to ask about the kidney transplant that if it is safe to do for my mother. My mother is 60 years old and has diabetic nephropathy, chronic kidney disease, GFR is 6. Creatinine is 543. Potassium is 5. She had congestive heart failure, severe mitral regurgitation. The ejection fraction is 35 %. She had hypertension, hyperthyroidism, dyslipidemia, DM controlled.
Hello. I passed carefully through your question and would explain that kidney transplant would be a perfect solution for her low kidney function, but it could be at high risk because of her heart function. You should know that heart failure has a reserved life-expectancy. You should know that only half of the heart failure patients survive after five years from diagnosis. Anyway, this depends on many factors: lifestyle, genetics, treatment, comorbidities, etc.  Besides, you should know that a kidney transplant can increase the risk for cardiac complications post-surgery, like myocardial infarction, etc. Being diabetic may indicate being also at an increased cardiovascular risk. That is why it would be necessary performing a Dobutamine stress echo or nuclear cardiac stress test before undergoing the kidney transplant, in order to investigate for the presence of coronary artery disease and undergo coronary catheterization if necessary, in order to avoid complications. So, you can see that benefits should be evaluated comparing them with the risks of surgery and heart complications. You should discuss with your doctor on the above issues.