Low-Protein Diet in Elder...

A lady aged 84 years was advised to prepare for dialysis based on her report of the estimated glomerular filtration rate (eGFR) decreasing below 15 mL/min/1.73m². She was a biopsy proved case of IgA nephropathy 40 years earlier, but since then, she has maintained an active and independent lifestyle. She was nondiabetic, had no history of recent hospitalization, non-obese( BMI 21 kg/m2, ) and hypertension was in good control. However, she refuses to start dialysis treatment and expresses her limited lifespan and desire to avoid dialysis if possible. Upon referral, her report exhibited overall good clinical condition, with a urea level of 180 mg/dL, creatinine of 5.4 mg/dl, she was non-oliguric, without any sign of volume overload. She had mild azotemic symptoms, with morning nausea,  appropriate albumin levels within an acceptable range for her age (3.5 g/dL). Additionally, a nutritional assessment indicates a high protein intake, which is appropriate considering her age (1.2 g/kg/day).