Nutrition for Dogs with Kidney Disease

sitting dog waiting for food bowl to be put down
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Nutrition is an important part of managing chronic kidney disease in dogs. If you have a dog with chronic kidney disease, it's important to work closely with your vet to make sure their diet is appropriate. Therapeutic kidney diets can help slow the progression of kidney disease and even reduce some symptoms.

Kidney Disease in Dogs

Kidney disease (sometimes called renal failure or renal disease) in dogs occurs when the kidneys no longer function properly. A dog's kidneys play a vital role in the body to:

  • filter waste from the bloodstream and excrete it in the urine
  • help maintain electrolyte and pH balance in the blood
  • produce hormones and enzymes¬†that help regulate some bodily¬†functions

Kidney disease in dogs can be acute or chronic. Acute kidney disease tends to develop suddenly and often occurs secondary to toxin exposure, infection, trauma, or another disease process in the body. Acute kidney disease is very serious and not all dogs survive, even with proper treatment. Those that recover may end up with chronic kidney disease.

Chronic kidney disease (CKD) develops because of degenerative changes to the kidneys that hinder their ability to function. The disease tends to develop gradually and gets worse over time, eventually leading to death. CKD causes waste products to build up in the blood because the kidneys cannot properly filter them into the urine. This is called uremia and can make dogs feel very sick.

There is no cure for chronic kidney disease in dogs. However, there are ways to manage CKD and slow its progression. Veterinarians often use a combination of treatments to manage CKD in dogs. This includes therapeutic nutrition that can help support a body with poorly functioning kidneys.

Nutrition and Kidney Disease

Dogs with CKD need proper nutrition to maintain body mass and support bodily function and it is one of the most important aspects in terms of management. Therapeutic kidney diets work to decrease the development of uremia and slow the progression of kidney disease while providing more calories to maintain weight.

When effective, these diets can vastly improve a dog's quality of life and even extend lifespan. Compared to regular dog food, there are some key differences in the way these diets are formulated to support dogs with CKD.


All dogs need protein in their diets, but too much protein can exacerbate kidney disease. This is because the kidneys process and break down dietary protein. Lower protein in the diet decreases the workload on the kidneys and minimizes the waste that enters the bloodstream. However, the protein content of food must still be adequate to support the dog's nutritional needs.


Phosphorous from the diet is also processed in the kidneys and is closely related to protein. Dysfunctional kidneys cannot adequately process phosphorus, leaving levels in the blood high and dangerous. Diets lower in protein are also low in phosphorous. However, blood tests may reveal that a dog's phosphorous levels are still too high. In these cases, a phosphorous binder may need to be added to the dog's regimen to reduce the amount that remains in the bloodstream.


Chronic kidney disease often causes low potassium levels in dogs. This can lead to muscle loss or weakness, low energy levels, and poor quality of life. Therapeutic kidney diets are often supplemented with extra potassium. Your vet may also recommend a separate potassium supplement to be taken orally.


Dogs with chronic kidney disease often develop hypertension (high blood pressure) as a complication. Elevated blood pressure can make kidney disease worse and it may even lead to a stroke. Dogs with CKD should eat low-sodium diets to reduce the risk of hypertension or to lower already high blood pressure. Therapeutic kidney diets are low in sodium for this reason.

Omega 3 Fatty Acids

Omega 3 Fatty acids are sometimes added to kidney diets or supplemented separately. It is believed that they can reduce inflammation and stress on the kidneys, slowing the progression of CKD.


Poorly functioning kidneys are unable to adequately filter waste out of the blood and into the urine. In addition, the kidneys cannot concentrate the urine. This sends thirst signals to the body so that more water enters the system. Dogs with CKD typically experience increased thirst and urination, so adding water to the diet is helpful. Your vet may recommend feeding a wet kidney formula or adding water to a dry kidney diet.

How to Feed Dogs With Kidney Disease

It's important for dogs with chronic kidney disease to ingest enough calories and nutrients on a regular basis. If your vet recommends a special diet to help manage your dog's kidney diet, it's important to gradually introduce the new diet while weaning your dog off the usual diet.

Some dogs will have a poor appetite soon after being diagnosed with CKD. Your vet may recommend starting other treatments first to help your dog feel better before starting a special diet. Throughout treatment, it's important to make sure your dog eats well. Talk to your vet if your dog is reluctant to eat the special kidney diet; they may recommend changing brands of food or prescribing an appetite stimulant.

There are several commercial diets designed for dogs with kidney disease. Most of these are specially developed therapeutic diets that are only available through your veterinarian. Common brand names include Hill's Prescription Diets, Royal Canin Veterinary Diets, and Purina ProPlan Veterinary Diets. To save time and money, your vet can likely help you set up food orders through a website that sells these foods.

Some dog owners wish to prepare a homemade diet for their dogs, especially if the dog is a picky eater or has other dietary restrictions. Be sure to discuss recipes and ingredients with your vet before attempting a homemade diet. The diet must be complete and balanced and properly formulated for dogs with CKD.

Foods to Avoid

Table scraps are generally not recommended for any dog. Some human foods can be unhealthy or even toxic. Healthy dogs can safely enjoy some table scraps like lean meats, bland rice or pasta, and some fruits and vegetables. However, dogs with chronic kidney disease cannot safely enjoy the same table scraps. Many human foods are too high in sodium and/or protein to be safe for dogs with CKD. Ask your vet if there are any humans foods you can safely feed your dog without having negative effects on the kidneys.

Dog food and treats designed for healthy dogs are not necessarily good for dogs with chronic kidney disease. Ask your vet which foods and treats are safe. Your vet may even be able to help you find dog treats made using a therapeutic kidney formula.

It is also essential to make sure your dog does not accidentally get into foods that could cause harm. You may need to feed other pets separately to keep their food out of reach. Cat food can be especially unhealthy as it is usually high in protein and also tends to upset the dog's stomach, leading to diarrhea and dehydration (a dangerous situation for a dog with chronic kidney disease).