If its stage 5 then prepare to start haemodialysis, avf creation with other supportive treatment

She requires optimisation of all the ckd parameters in the sense like management of anaemia, vit d deficiency, serum iron replacement, calcium, lowering of serum phosphorus, dietary modifications according to Ckd diet like avoiding fruits and fruit juices, coconut water, low protein diet, avoid pain killers, nephrotoxic medications, compliance with water, vaccination for Hepatitis B and last is creation of vascular access after 2 D ECHO.

With the above shared information, it is wise to prepare for Dialysis (either Hemodialysis via preparation of AV fistula creation or Peritoneal dialysis depending upon her abdomen girth status) anticipating near future need for renal replacement therapy.