I was always told its based on eGFR being below 15 when dialysis is needed. But, do not fear. My creatinine has been as high as 5.02 with an eGFR at 10-13 & Im not nearing dialysis yet. When I start vomiting, have toxins built up & swelling that wont go down then Im heading for trouble. When the dr wants your dad to have surgery to get dialysis access then his labs are showing his levels are getting close to needing it but if your father can stablize levels he will prolong the need for dialysis. I have an AV fistula in place now but its not fully matured. My 1st surgery was in July. Second phase was done in October. My creatinine is still in the 4.0+ range but Im still symptom free. Dont worry until your father starts having symptoms. Hopefully when & if the need arises for dialysis I hope he doesnt need an emergency port (in chest) as theyre prone to infections. Diabetes & high blood pressure are the two #1 causes for kidbey failure. Mine is from getting an ileostomy. A normal CKD diet does not apply to me. Ask the dr questions--you have that right to know what condition your father is in & what he's facing. Not every CKD patient is the same. Does your father eat a lot of meat?