puggy I'm so sorry that you're going through this.
For me, i had a mass of pregnancy tissue that was 3 inches in diameter and it was all of the way through my uterus wall, when they gave me the methotrexate it didn't leave a hole, it killed the tissue and the uterus muscle healed itself.. I was told them doing a d&c would likely rupture the uterus... if I were you I would ask again for the methotrexate....unless the kidney issues are too much... again I'm so sorry.
For me the actually admitted me to hospital for 5 days, gave me the methotrexate and did lots of blood work and ultrasounds to make sure it was working..if it hadn't worked they would have had to do a hysterectomy...
big hugs.