My Neko had both a heart murmur and stage 2 CKD when she had her second SRT (stereostatic radiation therapy) to treat her acromegaly tumour. I had it done at Colorado State University. They had me get an echocardiogram and recent blood work before I went there. Do you know what is the issue with Hamilton's heart? Later on Neko got a 2nd degree heart block and could not undergo anesthesia.
There are other options - if you know for sure that Hamilton has acromegaly. Some of the people here have had success with a drug called Cabergoline.
Here is a post with more information about it.
The acro sticky notes need a little updating. Sorry, it's on my "to-do" list.

And here is another post with some
collections of articles on acromegaly. Again, my bad, I have to put some of the medical solutions (pasireotide and cabergoline) articles on there. Unless you are really rich, pasireotide is probably not one you would consider. And if you read
Yum's post from yesterday, MJW just got the acro diagnosis and her post has a lot of information in it on treatment options.
In the mean time, gettting to a dose where he spends most of his time under renal threshold is a good goal. Other things you can do to help him are to spread his meals out a little. Neko got several small meals in the first half of the cycle. It helped curb her voracious appetite. At some point, if you find Lantus stings Hamilton (which it's acid base can do at higher doses), you may fine a switch to Levemir insulin helps.
And lastly, what meds/supplements is Hamilton on? It can help to put when you stop or start meds into the Remarks section of the SS, to see if there is any corresponding result in numbers. And speaking of numbers, for the Labs page of the SS, we need to see the reference ranges for the lab you are going to. They do vary by lab, and the measures are different in the US than the rest of the world.