By the time a diabetic patient requires dialysis, there has been a certain toll taken on the body, although the renal physicians now tend to start earlier to try and lessen the toll. The current symptoms certainly seem to be related to the fact that he is back on dialysis, has heart failure and a low haemaglobin. The weight loss does need to be looked at, but may from the heart failure and being on dialysis. Your last question is difficult, and should be answered by the renal doctor, as it would be unfair of me to comment not knowing the patient, i.e. I don’t know the extent of his current heart failure, and also whether he is line for another kidney or not. I also don’t know if he has any other complications from diabetes like nerve damage or vascular disease involving his legs. Certainly I have patients on dialysis who are still able to work, and so I think you need an honest answer from your current doctor.
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