We do dental work including extractions all the time on cats with chronic renal failure, heart problems, liver problems and many other problems. The vast majority do just fine. Have your vet do preop bloodwork on her (him?) to check the current status of your kitty's condition. There are ways to adjust the preop sedation-- we have lots of different drugs to use beforehand as sedatives. In our practice, we use diazepam with glycopyrrolate instead of acepromazine and/or ketamine on our renal cases, and it has worked very well. The gas anesthesia we use is isofluorane, which is excreted via the respiratory system rather than the kidneys. It's fast-acting and is cleared very quickly. They go under fast, and they wake up quickly. Your vet can adjust the anesthesia level to provide the minimum level needed to do the job. You might also ask about monitoring your kitty during the procedure with an EKG, or pulse ox (they'll know what that is), or some other electronic monitoring-- which ought to be standard anyway. They might even put her on IV fluids during the procedure, though most extractions and dental procedures are very brief procedures, less than an hour.
I can clean a full feline mouth (ultrasonic scaling, irrigation, periodontal check, polish, fluoride treatment and sealer-- not counting x-rays if needed) in about 35 minutes. Dogs take a little longer, but they have half again as many teeth-- 42 dog teeth to 28 cat teeth-- but it's still only about 45 minutes. If there are many extractions or other oral surgery, of course it takes a little longer yet depending on what teeth need to go and the complexity of the extraction or procedure. It sounds like you cat needs only one tooth pulled, based on the wording of the question. So it shouldn't take all that long. I don't know from your question if your vet was also going to do a cleaning like I described.
Dental problems can cause problems elsewhere in the body. In fact, unresolved dental problems are the biggest preventable cause of kidney problems in cats. If your cat already has renal problems, taking care of her teeth is even more important to preserve her health.
Anesthesia always carries some risks, even for healthy pets and people, but your vet can take steps to make the procedure as safe as possible.