Stage 4 ckd with Congestive Heart Failure

[thomascald]

I was in the hospital last month for my CHF. Lungs were filling with fluid and couldn't breathe. I am 47 years old. They checked my kidney function as I also have CKD. My eGFR was at 23 and ejection fraction of the heart at 22% They took me off my Lisinopril because of my kidneys and replaced it with Hydralizine, which is giving me horrible headaches. They are going to implant a defribilator next month due to sudden cardiac arrest. I see my Nephrologist next week. I am going to see if I can get ready for dialysis as they already asked if I knew of any family members for a transplant. I figure the dialysis would be better as i feel I would rather save my heart and keep my blood pressure down with the ace inhibitors, I can live longer with dialysis but nothing to save my failing heart. Any opinions?

[Bassetmommer NKF Ambassador]

Hi Thomascald,

A GFR of 23 is a number you can live with if you learn the things needed to protect the kidneys. It is wise to learn about dialysis, but you may not need it for while. See if you can get a referral to a renal dietician to help with a lifestyle diet that will help with both you cardiac and renal issues. What you eat is as important as the medications you take.

Take things one step at a time. Let us know how your appointment goes with the nephrologist.

[thomascald in reply to Bassetmommer]

You're not understanding what I'm saying. I need to be on ace inhibitors but can't because of my kidneys, that's what my cardiologist said. But doesn't want to because I'm not on dialysis. Would rather save my heart than my kidneys.

[Bassetmommer NKF Ambassador in reply to thomascald]

Ahhhh sorry, but you can be on both. Speak with the nephrologist to see what they recommend and they should work with your cardiologist. You want a team of people who have your total health in their care and not one against another. There are many drugs, as you know, that are nephrotoxic but then there are others that are not. Many people suffer from high blood pressure and have CKD. I am one.

I just wanted you to understand it is not one or the other. You can take care of both your heart and your kidneys. I would be concerned that your cardiologist said it was one or the other.

[KidneyCoach NKF Ambassador]

You're getting ahead of yourself. Transplant centers would consider evaluation and listing once your egfr is at 20%. However dialysis usually doesn't begin until egfr is below 10%. I don't think any transplant center would consider listing you because of your heart failure. Unless you were considering a dual heart/kidney transplant. Generally TC wants potential recipients to be as healthy as possible. (Imho)

There are still things you can do to preserve kidney function and protect your heart. Request a referral to a renal dietitian, discuss all of this with your nephrologist.

Check out kidneyschool.org

Blessings

[Jayhawker]

My father had serious cardiac issues including heart failure with a low ejection fraction like yours. He lived for many years (12-15 years before dialysis) with appropriate medical care and strict adherence to a heart healthy renal diet. Perhaps even more importantly, he felt and functioned well fir much of that time.

Of course every case is individual. However, it sounds like it would be helpful for you to try to get all your doctors in a meeting together; perhaps a conference call of telemedicine appointment they can each bill out to attend???

Then a solid renal dietician who also has knowledge of heart healthy diets.

Im sending you nothing but good thoughts and hoping to hear back from you to let us know how things are going.

Jayhawker

[RoxanneKidney]

I hope that your situation inproved. Sending prayers.