M.K.
You said that you needed a frank opinion, here it is: at 45 the chances for you to conceive a healthy child with your own eggs are minimal if you are perfectly healthy.
I know women don't usually go around openly and telling everybody, but I personally happen to know a lot of "very late moms" (first child between 45 and 50) and almost all of them went with donor eggs and all of them did IVF. Those celebrities that have a baby in their 40'ies, I will bet you that 95% of them did donor eggs and/or IVF.
No self respecting doctor would consider you as a patient for IVF, if you were to get pregnant with your health problems, you would likely be advised to terminate. Something around 1% of dialysis patients are able to get pregnant and only a small fraction of those pregnancies even make it to the second trimester - often at great cost for the moms health.
I do understand the wish to have a child, but you should really look at other avenues. Maybe foster care? Maybe foster to adopt, which is more affordable than a private adoption or surrogacy?
Getting pregnant is only worth it if you actually get to live to raise your baby...