Steady decline in GFR - feeling devastated.

The dyes used in testing like an angiogram, cardiac cath or any test using contrast dye.
They definitely don’t begin dialysis for a Creatinine of 2 or 3 or even 4! Everyone is different, remember.
You have a way to go.
Continue what you are doing & visit those 2 websites for the CKD diet.
But also, realistically, he is 91,and if he enjoys eating foods he isn’t supposed to I would allow him that.
Unless something stresses out his kidneys now to tip him into CKD 5 I would hypothesize he won’t die from renal failure. At his age he is fragile and many things could happen, so take what I say as a non expert but an old RN.

With your dad having both heart and kidney issues, you may want to try palliative care for him. This is not hospice care and there is no 6 month rule for care as there is with hospice. Palliative would provide a care team whose focus is comfort but still maintain his current medical protocol. However, palliative care is usually provided by a hospice agency.

Hanna, I think what you (and father) are looking at may be no good options. I just want to encourage you to try to come to peace with the fact that 91 is a "ripe old age" and that no one lives forever...but thinking our LO may suffer IS devastating. You have every right to feel this way. My 85-yr old MIL just "recovered" from covid. It seems she will not go back to being her prior self, which is not saying much. Now her cognition is worsened and she doesn't want to eat and barely drinks and the NH can't force her. She is still not off oxygen. The thought of her (probably) slowly fading from malnourishment is unthinkable, especially since we can't even visit her. She can barely carry on a brief phone conversation. Putting your father through further treatments may not improve him much, and may distract from having quality time together with him, whatever time he has left. If he can be made comfortable that may be the best thing for him, even if it doesn't feel that way for you and your family. I sincerely wish you peace in your heart as you journey on this path with him.

"If your estimated glomerular filtration rate (eGFR) is 24 milliliters per minute per 1.73 meters squared and if it has been present for at least three months, then you have Stage 4 (out of 5) chronic kidney disease (CKD) and should be followed by a nephrologist."

From what you wrote, you already know he is in stage 4.

"Water ingestion can acutely affect GFR, although not necessarily in the direction one might expect. Using 12 young, healthy individuals as their own controls, Anastasio et al. found increased water intake actually decreases GFR."

From the above, it looks like drinking more water doesn't really help.

Your Dad is 91. His body is wearing out. I think you just need to enjoy the time you have together. Be glad you have had him this long. Not everyone is so lucky.

Hello Shane1124,

thank you for your reply. After his lab results from january I was hoping that the decline was slowing down. His creatinine is 2,26 mg/dl. Dialysis is totally out of the question.

H

What is his creatinine? Reviewing his labs there is a decline but he can stay at CKD 4 for awhile. They usually start thinking about starting dialysis with a GFR less than 15. So you have a way to go.
I am not sure I would begin dialysis on a 90 year old unless he was Jack LaLaine. Hemodialysis is grueling on a body yet alone a 90 y/o.