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After a year and a half of bladder issues (still not figured out after seeing multiple urologists), my 80-year-old father has stage 5 kidney disease. They think his bladder has been retaining and that has caused issues to the kidneys. I stopped counting how many UTIs he had. He's going to start dialysis soon. The crazy thing is that he went from weighing about 180 lbs at 6'1'' in April 2019 at the start of this journey to 148 lbs today. Is it normal to lose that much weight? Yes his appetite has fallen, but he is trying to eat a lot more. I guess I've always thought there was something going on here and not just kidney disease but maybe I'm wrong? Also, does dialysis help to increase weight?

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Kidneys, heart, and lungs are the three major systems you just cannot do without. That any one of them is impaired often has repercussions on the other two systems, and like dominos falling..................
Does your father truly want to prolong life with kidney dialysis? I have, as an old nurse, written in my advanced directives that I will not accept dialysis or artificially delivered nutrition and would enter hospice at this point. I am hoping your doctors have explained just what dialysis means in terms of the upheaval in your life, and that this is an informed choice.
That said, wasting and loss of weight follows no incentive really to take proper nutrition, and can follow disease. I can't know what tests and scans your Dad has. Dialysis may improve his general health a bit, but the truth is that it is a long slow slide down in most cases. And often the weight you see is from systems failure allowing fluids to accumulate in the body in third space under skin and in lungs.
Learn all you can and help your Dad with further decisions as he moves on. His prognosis is likely now very unpredictable. I think your questions of whether there is some "hidden reason" that could be being missed due to the KNOWN condition in the kidneys, is s good one, but is one only your father's doctors can help you with.
I am wishing you and your Dad the best luck ongoing. You cannot really know now how much better or worse he will feel in future. This is a one day at a time kind of thing.
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If he’s not eating and has had CKD 4-5 than 30 lbs over a year and a half is not an unreasonable loss. Patients are losing 50 lbs from being hospitalized from Covid in much less time.

When someone doesn’t eat the body begins muscle wasting which causes weight loss because the body isn’t getting nutrition from food. End stage renal disease (which developed over those 18 months) will cause a lack of appetite as well as often food doesn’t taste right anymore.
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Assuming other more common causes of weight loss have been discounted, like diabetes, ulcers, etc. My BIL just found out his 15-lb weight loss was from an ulcer.
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I guess everyone is different, but, my aunt just started dialysis and she hasn't lost any weight, though, she would like to. She's in her 70's. Have they checked his blood sugar levels? High blood sugar levels can cause fast weight loss, even if you are eating lots of calories.
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