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Diet for Pets With Kidney Disease

Pet Diet & Nutrition 4 min read
Brown and white short-haired cat eating out of a metal food dish with a metal water dish next to it

Chronic Kidney Disease (CKD) is one of the most common conditions in elderly dogs and cats, although it can appear at any age. Finding the right diet for pets with kidney disease is an important part of managing this condition.

Chronic kidney disease is characterized by abnormalities in kidney function and/or structure. The first clinical signs that your furbaby may have CKD are an unexplained increase in water intake, resulting in an increase in urination (and the pee becomes very clear, looking like water) and loss of appetite.

Unfortunately, CKD is one of the most common causes of death in cats and dogs. Usually, the pet shows the clinical signs only when approximately 75% of renal capacity is compromised. The diagnosis is based on some of the values seen in blood work (creatinine, urea, and urinary density) that give some clues about the health of the kidneys.  

CKD is a progressive disease but can be managed with dietary changes associated with other measures (pharmacological and/or homeopathy, acupuncture, ozone therapy, nutraceutical medicine, etc.).

Creatinine levels are evaluated based on the classifications from the International Society of Renal Interest –IRIS, and can tell us if the pet’s diet needs to be changed for a “renal-friendly diet”.

A renal-friendly diet is built to meet the pet’s nutritional and energy requirements and at the same time minimize the clinical signs.

Recommended Dietary Changes For Pets with Chronic Kidney Disease

Phosphorus Restriction

It is the most important change, as it is able to slow the progression of the disease. Some authors state that phosphorus dietary restriction is the therapeutic intervention that should have priority. According to the IRIS recommendation, the supporting food should be used in patients in stages II, III, and IV of CKD since from stage II on, most animals start to present hyperphosphatemia (increased levels of phosphor).

A diet that is low in phosphorus may increase the life expectancy of the pet by approximately two and a half times, compared to a pet who received a diet without this restriction. A study has shown that only 33% of the animals that received a diet that is low in phosphorus had renal complications, while pets that received a diet that did not have phosphorus restriction, the number of deaths due to renal complications reached 65%. The data from this study shows that phosphorus restriction is extremely important in pets with CKD. It is also important to point out that phosphorus restriction is essential to decrease the risk of Secondary Renal Hyperparathyroidism, common in pets with CKD.


Moderate restriction and highly digestible protein with low mineral content are recommended. This strategy allows the reduction of nitrogenous residues and phosphorus, without causing protein or amino acids deficiency.

Adequate amino acid intake is extremely important to prevent cachexia (weakness and wasting of the body due to severe chronic illness), especially in cats, which are carnivores. Moderate protein restriction can decrease the risk of uremia (high levels of urea in the blood) and reduce proteinuria in pets with CKD.

Sad looking yellow lab dog laying next to an empty food bowl. Diet for pets with kidney disease

Energy Density

It is important that the diet contains high energy density, as loss of appetite is quite common in pets with CKD. The use of non-protein sources of energy is interesting because in this way the protein is saved to maintain the body mass. Some source of fat, for example, present in some types of fish, is an excellent source of energy for cats and dogs, in addition to increasing palatability to food.

Omega 3 (EPA/DHA)

Supplementing the diet with omega 3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) has an interesting role in renal physiology, as they promote the reduction of the inflammatory process.

NHV Petomega 3 is a human-grade quality fish oil that is naturally rich in omega 3 fatty acids. Petomega 3 is made from the oils of sardines, anchovies, and North Atlantic cod. It’s an excellent source of EPA and DHA and is molecularly distilled and cold-pressed to improve bioavailability.

Balance of Vitamins, Minerals, and Antioxidants

Although the main means of treating systemic arterial hypertension (high blood pressure in the arteries) is medication, sodium levels should be normal to moderately reduced. Studies suggest that curcumin supplements may promote the dilation of blood vessels, increasing blood flow and reducing blood pressure.

Antioxidants and vitamins, especially of the B complex, must be provided via diet. Antioxidants are important for reducing oxidative stress from chronic injury, and reducing disease self-progression. Due to the presence of polyuria (excessive urination), polydipsia (excessive thirst), and vomiting in CKD cases, the loss of water-soluble vitamins is great. NHV Multi Essentials is an excellent source of antioxidants and vitamins.

Grey and black striped cat drinking out of a class water bowl. Diet for pets with kidney disease

Wet Food

A wet diet helps to keep the pet hydrated and also helps the kidneys to eliminate the toxins. A homemade diet would be the best. However, there are many wet food options commercially available for pets with CKD.

Pets with CKD often experience appetite loss and easily get tired of eating the same food. So, if you are okay cooking for your pet, you can change the recipes for one that pet will enjoy and entice them to eat.

Additional Kidney Disease Support For Pets

Thus, the use of supplements formulated for renal support such as Tripsy and Milk Thistle have an important place in the management of this disease. They may contribute to the maintenance of renal function by delaying the evolution of the disease, contributing to the improvement of the quality of life, and increased life expectancy in significantly affected pets.

If you need help ensuring that your pet battling CKD has a balanced diet that is right for their condition, I offer personalized nutrition plans. These nutrition plans include recipes and a guide on how to cook meals balanced for your pet’s specific needs at home.

If you have any questions about your pet’s condition or diet, our team of pet experts is here to help. Click the chat button below to start chatting with us now.

Dr. Amanda Nascimento DVM, MVSc, PhD

Dr. Amanda Nascimento DVM, MVSc, PhD

Dr. Amanda completed her undergraduate degree in veterinary medicine in 2010 and graduate studies in veterinary pathology (MVSc. 2012 and PhD 2016) at the School of Veterinary Medicine, University of São Paulo. She completed her post-doctoral training at the Western College of Veterinary Medicine – University of Saskatchewan in 2018. Dr. Nascimento will be hosting her own blog series and sharing her knowledge with our extended NHV family.

Published: February 17, 2021

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