I just saw your question. I wonder how things have gone for your dad. My dad died from CHF, and now my brother has it following a heart attack. The high urea is probably causing the dry heaves and nausea, and the other numbers don't look good. I think you mean BNP (not BMI). I never knew that the BNP could be 5000. The BNP is an indicator of how much stress the heart is suffering from the CHF. For example, the BNP will go up when the patient is "wet" or loaded with fluid (edema) because the heart and kidneys are in distress trying to manage the overload. CHF is very difficult to manage especially toward the end stage. I hope you and your dad have an easy time of it. Best of luck.
Normal creatinine level is around 1.1, but the number you are needing is his GFR. Dialysis is usually started when the GFR falls to 15 or below.
My creatinine ran around 4.7 for several years, it is now up to 5.9, and my GFR is 8. I will be starting dialysis as soon as my dialysis fistula is healed enough to be able to insert needles into it.
There are 5 stages of kidney failure. Stage one is a GFR of 130-90, stage two is 90-60, stage three is 60-30, stage four is 30-15 and stage five(end stage renal failure) is 15-0.
I can't answer your questions about the heart, as I just don't know enough. Even though I suffer from CHF also. I do wonder about prednisone, though. Everyone I have ever known who had to take it, had terrible problems with swelling. Prednisone is usually used to keep the body from rejecting a tranplanted organ.
Is your dad on any kind of diurectic, such as lasix? It seems to work real well for me, along with diet and all of the exercise I can do safely. I've managed to stay out of the hospital for swelling for 6 months, and at that time I came close to drowning in my own body fluid, so I think lasix is a great medication,.
I notice you're in Washington State, does your dad see a cardiologist and kidney specialist? Washington State has some of the best in the world, and chances of survival for kidney and heart patients goes up about 18% just because they live in the Pacific Northwest. So, if you can't find the doctor at the hospital, then find him at his office. Make an appointment if you have to, and then go prepared with all of your questions written down, and don't let him go until you have the answers you seek.
I hope all the best for you and your dad...keep us informed.