### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, my father had axcel bi femeral bypass surgery to get rid of an infection.  This caused acute kidney failure.  His Creatinine level was up to 4.9 ish. He has been on dialisis several times now with his levels bearly moving after each treatment.  He is currently at 3.7.  He is also in congestive heart failure.  At what point would he need to have a transplant if his levels dont get undercontrol?

### output:

Hi, kidney disease is broadly classified as two types. Acute kidney injury and chronic kidney disease. In AKA, the chances of long term dialysis is less and patient recovers with time with normal kidney function. But in CKD, patient is on regular hemodialysis for long time or frankly say for lifetime. In that condition, we should consider Kidney transplant. Because dialysis is not a cure, it only prolongs the life expectancy along with some patient well-being. So for permanent cure, you have to think about kidney transplant. But kidney transplant is not so easy process. Before it a battery of investigations are done to find out how is the risk benefit ratio. If all important factors are favorable then we proceed for transplant. In your case, one major risk is Heart so first cardiologist asses the heart function, and then he will tell you about how risky is this process?there is no specific criteria for creatinine level for transplant. If creatinine level is stable without dialysis and patient has no symptoms then better you can wait for transplant. But if he needs regular dialysis to control creatinine level then better you think for transplant. Heart failure patient can be taken for transplant if he has good ejection fraction. So you can go for kidney transplant if he has CKD with good ejection fraction of heart. Thank you