With the kidney disease, open heart surgery is most likely not an option. Normal heart valves start mildly leaking at around age 40. It could be completely normal for his heart valves to be leaking a little for his age. Valve replacement surgery or valve repair surgery is a complex surgery and a difficult one. I am not sure if I would even to brave enough to go through it at my age of 44. I have seen many in our family go through this and it was horrible each time. One survived and her life afterwards was difficult. On another note, valves sometimes get better on their own. I have talked with several people in their 80's who told me that their valves just got better.
It is not uncommon to have leaking valves. If you have a copy of the echo report, what is the EF, that would indicate the degree of heart failure? Does the right ventricle and left ventricle have normal dimensions (also on the report) that would indicate any progression of heart failure and prognosis?