How do you tailor protein intake recommendations for older patients with stages 3-5 non-dialysis dependent CKD, considering the unique metabolic and physiologic factors that influence protein metabolism in this population?

Personally, I would not restrict their protein intake. I would encourage good protein source intake such as eggs, chicken and fish. If serum BUN is very elevated, then it may be worthwhile discussing lower protein intake. If patient become uremic then dialysis should be discussed if indicated.