Mystery CHF, Kidneys, Stupor

Hello,

My brother is a 65 yo Caucasian.  He has been hospitalized three times (avg 7 days each time) in the last 6 weeks.

Twice he went by ambulance to the ER with astronomically high blood pressure and stupor like symptoms.  He could stand but his eyes were rolled back into his head.  He was in a coma like state for 4 days the first trip.  He could recite his birthdate and full name but was not voluntarily talking.  He had slurred speech but MRI or CT Scan ruled out current stroke, only two old ischemic incidents.  He showed no other stroke symptoms.  He had no chest pains but has CHF with swelling in his abdomen.  He has one working kidney.  The other one was supposedly rendered useless due to hardening of the arteries.  His kidney function is below normal.  His sodium is low.

The third trip was 10 days ago.  He was admitted with chest pain and stupor but low normal BP.  Doctors are perplexed.

He is well controlled with meds for bi-polar. He was taking Risperadone, Depakote, and Effexor.  It was thought that his meds were overwhelming him.  His Effexor was changed to Zoloft.  He is also on Co-Reg,   A HHC nurse visits his home to regulate his meds.

Years ago he had a MI and a bypass.  It was said on the last treadmill test that it was abnormal with blockages.  Cardiologist said his kidneys are not good enough for him to go through a heart cath.

Any ideas?  He was on Lovenox daily while in hosp.  His reoccurrences are usually about a week after he is dismissed.  Yesterday, he was slipping into a stupor and phoned me and I asked him to chew 2 aspirins.  He stopped slurring and  got OK.

Is there a way to have a heart cath where it does not harm the kidneys?  Our DRS don't work together.  We are frustrated.

Thanks,
WornOutPump