I have 92 year old grandfather, with history of strokes ,bleeding of front lobe brain. History with high bp ,CHF, recent diagnosed with less that 10 % kidney function. Lately , feeling nausea , appetite not well some days less than 25% consumption. Headaches, fatigued. My question is how do I know that his kidney failure is progressing worse .. he refuse to have dialysis
Hello and welcome to Chat Doctor. As a Urologist, let me advise you that, 10% kidney function is as good as no function in kidneys.  Its also called end stage kidney disease(ESD). Normally, dialysis is urgent, as dialysis is like an artificial kidney. You should convince him about need for dialysis, as body wastes are filtered through the kidney, into the urine. At his age, with so many other medical problems, it's even more urgent. If you've any other doubts, you may send your question here, in my name.