92 yr. old dad with chf and 3rd stage kidney failure. now is eating very little but drinking ensure/ normal decline for his problems?

COMMON: Not normal but common in the elderly with chronic disease. Make sure the ensure is a renal failure formula.

Class 3 CKD: Let's make sure we are on the same page here. I assume that your 92 year old dad has class 3 chronic kidney disease (ckd), not kidney failure. At his level of ckd, he should not need dialysis. Ask his neprhologist to get a 24 hour urine for creatinine clearance. If the result is > 20 mg/min, he is not uremic and does not need dialysis. Look for other causes of poor intake, other than his ckd.