my father is renal failure patient from last 7 years and undergo dialysis thrice weekly..He is HCV+ and also has heart problem he had PCI in 2005 and his ejection fraction is 35% .Now his major problem is that he has parathyroid adenoma from last one year due to which there is extensive calcification in his body (echocardiogram and other tests suggest that) his PTH level went to 8500 but than he started taking cinacalcet and that came back to 2500 and is persisting at that level.So now my questions are that what should be done for his parathyroid problem ? should he go for surgery or he should have ethanol injection for which we are planning to go to Singapore and 2ndly with EF of 35% which is due to his dialysis and this calcification will he ever be able to have a renal transplant? I am his son and am really worried about him ..kindly guide me about how should we proceed and what should be done?
I think the treatment options for his parathyroid issues should be discussed with that physician; I can tell you that because his EF is below normal, he will be a higher surgical risk than someone with a normal EF. Pertaining to his transplant status, there are many factors that go into that including age and health status and from what you are telling me I think it is doubtful he will be a transplant candidate but that should be discussed with a transplant specialist. I apologize for not being more helpful, but this is a very complicated situation-- one that requires a conversation with multiple specialists; the surgeon potentially doing his surgery, his nephrologist, and his cardiologist. I encourage you to have a lengthy conversation with these physicians at a "team meeting." Good luck
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