Stage 4 Kidney Disease and Knee Replacement. Anyone have experience with this?

As long as you are not MILs caregiver (and won't be to help her reciver from the surgery) let her go ahead with it. It's her life and her choice. If she knows and understands the risks and consequences of said risks in regards to her independence and possibility of a nursing home should things go wrong.

As long as the kidney doctor approves it she can go ahead with the knee replacement. Unless surgeon will do it without the kidney docs blessing.

I have to ask...
How active is mom?
How much pain is she in on a daily basis that can not be controlled by medication?
Will she be able to take medication for pain after surgery?
Will she be able to participate in rehab?
Is she pretty strong now? With the surgery she will have limited use of the knee to bear weight so upper body strength as well as strength in the other leg/knee will be needed.
Is the surgeon fully aware of her kidney failure? What does the anesthesiologist have to say about it?
And I guess lastly
Ask her all the questions that are on a POLST form.
Would she want CPR? (does not always work and will break ribs and crack sternum)
Medical intervention:
Primary goal sustaining life
Selective treatment
Comfort Focused
Medically administered nutrition:
Long term
Trial period
None
Intubation:
Yes (this would probably be included with Full treatment during intervention)
No

And make sure she has her POA for health and finances in order (if they are not) and make sure medical POA is aware of her wishes.

Personally if it were my mom or if it were me I would opt not to have knee replacement.

Sunnydaze

I do not know how far along her kidney failure was at the time, but my late aunt, while in her late 80s had a knee replacement and did fine.
I know she already had kidney issues, had for years. Hers was Tylenol overuse. She died at 93 after a fall on her way to dialysis. She had only been on dialysis for about a year, so she had several years with a replaced knee. The same knee had been replaced many years prior and had worn out. So she did have an idea of what it entailed.
A difficult decision perhaps on encouraging/discouraging your MIL. She is lucky to have you helping her gather all the pertinent details.
My aunt was one who made her own decisions and wasn’t looking for our opinions. Her husband died less than a year later.
Hopefully you or DH has her POA and she has all her affairs in order. AND that you are not setting yourself up to be primary caregiver whichever decision she makes.

Let us know how this goes. We learn from each other. Good luck!

Thank you for mentioning clearance/refusal!

If she is stage 4 her GFR could decline enough to emergently put her in needing dialysis. I am in stage 4 and on dialysis but I am only 66. I would not be wanting to have a knee replacement and anesthetic. I've had some minor stuff done and each time I've been put to sleep it has been harder to recover.

Medicare and her supplementary insurance company may not approve the surgery, considering her health problems. You could check into that.

The doctor can refuse to the surgery if kidney doctor does not give clearance. I would contact the surgeon and make him aware that the kidney doctor is not for the surgery. Or the kidney doctor call the surgeon and tell him he does not recommend the surgery.