Thank you for your query at DoctorSpring.com.
Elderly woman with diabetes and hypertension along with heart disease are supposed to develop a gradual deteriorain kidney function. Its further compounded by the advancing age, infections especially in the urinary tract, drugs , dehydration, fall in pumping cation of heart ( low ejection fraction), etc.
She has Chronic Kidney disease (CKD) due to diabetic nephropathy. It can be proved agagin by the presence of diabetic retinopathy.
So, She needs to get her eyes checked up. She also needs to get evaluated for calcium, phosphorus, uric acid, Iron profile, B12 and folic acid and vitamin D aling with thyroid profile.
She requires to be given conservative management for CKD. I suggest you to get her evaluated bya nephrologist at your locality and get a prescription. Avoid any kind of nephrotoxic drugs, dehydration etc
Feel free to discuss further,
Dr. Sree Bhushan Raju
MD, DM (AIIMS), DNB, FISN, FICP, FIACM