Q: My relative is 73 years old. He underwent a bypass 5 years ago. Recently he was hospitalised. His ejection fraction is 20%; his blood sugar is 550 (fasting); creatinine is 1.8 and nitrogen 34%. What are his chances and the probable life span duration?

A:Your relative has multiple risk factors which suggest a poor prognosis. However, I have never tried to predict how long someone will live especially with potentially treatable factors. Clearly his diabetes should be aggressively managed with insulin and/or oral medications. I am assuming that he is on an ACE inhibitor such as Ramipril for his heart. Hopefully he is taking aspirin and a Beta blocker for his heart as well. The ramipril or similar drug will also protect his kidney, in part, against more rapid deterioration. There are other factors which should be considered such as his blood pressure, his lipid profile, the usCRP all of which should be aggressively managed. Many patients can survive for years if their medical problems are managed aggressively.