Congestive Heart Failure & Kidney Failure

My Father is 78 is congestive heart failure (at 12%).  In the past he has had mild kidney failure but within the past few months the kidney failure numbers are increasing (3.1 - 3.5).  What can we as a family expect for his quality of life and how to take care of him.  I understand no one has that magic wand to wave telling us how long he will live but on an average what could we expect?  We want to make him comfortable and stay at home as long as possible.  Just looking for some facts and experience along with how to deal with some of this...

[kenkeith]

It is difficult to assess one's condition when there are concomitant health issues.  My heart's EF was in the heart failure range (below 29%) going on 8 years, and currently it is functioning  normally with medication. The underlying cause was occluded coronary vessels and high blood pressure.  Opening a coronary vessel with a stent and medicaiton to manage blood pressure is/was the treatment.  My symptoms included lung congestion (edema) and that was due to the inability of the heart to adequately pump sufficient blood from the lungs and the blood backed up into the lungs causing fluids to leak into the lung tissues.  A diuretic med helped reduce the fluids and med to reduce the heart's workload was the therapy.  

The symptoms your Father is experiencing would help assess your Father's prognoses.  The end stage would be when your father has chest pains (angina) at rest and shortness of breath with very little exercision .  If medciation is ineffective the heart will enlarge and that can/will cause cardiac arrest.  I believe your father can stay home but may require hospital treatment for lung congestion periodically if medication doesn't help.  My experience with the congestion feature of CHF required a few days in ER to drain and stablize the oxygen level.  If medication  can keep your father's heart size within the normal range, he may have many years left.

I'm not sure of the significance with the kidney issue, but a poor functioning kidney can complicate the congestion feature of the low EF and may or may not be significant.  Hope this helps and I wish your father well going forward.  If you have any further quesitons or comments you are welcome to respond . Take care,

Ken

Ken