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Your dog's nutrition is important for a healthy & happy life. petMD experts help you to know what to feed your dog, how much food to feed, and the differences in dog foods, so your dog gets optimum nutrition.
Nutrition Nuggets is the newest offshoot of petMD's Dog Nutrition Center. Each week Dr. Coates will use her expertise and wisdom to blog about the intricacies of dog nutrition.

Nutrition's Role in Treating Kidney Disease in Dogs

April 11, 2014 / (8) comments

Chronic kidney disease (also known as renal disease) is an irreversible and progressive loss of kidney function that ultimately results in illness and death. It is most common in older pets, but can occur at any age. Even though the disease is progressive, appropriate treatment helps many dogs live comfortably for several months to years.


In the past, even with medical treatment that consisted of controlling high blood pressure, the loss of protein through the urine, and hyperparathyroidism (resulting in an imbalance of calcium and phosphorus), dogs were likely to die shortly after diagnosis. However, numerous studies now show that feeding these patients a therapeutic renal diet is the most successful tool in managing chronic kidney disease in dogs. Kidney diets help to reduce the progression of the disease and prolong survival times.


Several nutrients are important in the dietary management of chronic kidney disease:


1) Phosphorus – a mineral that is consumed in the diet and needed for all living cells in the body. It is present mostly in the bones and teeth, less so in soft tissues and extracellular fluids. It is excreted from the body through the urine. Studies show that restriction of phosphorus in dogs with Stage 3 (out of 4) kidney disease increases survival time.

2) Protein – Two schools of thought have duked it out with regards this nutrient.

Reduced protein diets result in less nitrogenous waste that needs to be excreted by the kidneys and lower phosphorus levels (because protein contributes to increased phosphorus levels).

Increased or normal levels of good quality protein help to maintain lean body mass (and maintain strength, coordination and good immunity) and have no adverse effects on life expectancy as long as phosphorus intake is restricted. Current recommendations are to provide adequate, good quality protein and reduced phosphorus levels.

3) Omega-3 Polyunsaturated Fatty Acids – essential fatty acids that are not made in the body and need to be present in the diet. In particular, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are omega-3 fatty acids that help reduce inflammation and reduce glomerular hypertension (glomeruli are part of the kidneys), consequently improving kidney function. Omega-3 polyunsaturated fatty acids are most abundant in fish oil.

4) Antioxidants – substances that help neutralize free radicals. If not dealt with, free radicals can cause significant cellular injury and produce more free radicals. Renal diets that have both omega-3 fatty acids and antioxidants combined are better at slowing the progression of chronic kidney disease than either one alone.

5) Fermentable Fiber – adding this type of fiber to the diet promotes the excretion of nitrogen in the feces and allows dogs to consume adequate amounts of protein. Renal diets that are supplemented with fiber from beet pulp, fructooligosaccharide, and gum arabic help increase the number of intestinal bacteria, which draws urea (a nitrogen-containing waste product) into the feces.


Multiple studies show that in dogs with Stage 3 kidney disease, renal diets are superior to regular maintenance diets in slowing the progression of chronic kidney disease and prolong survival time. In one study, 70 percent of dogs on a renal diet survived three times longer than did dogs who ate a maintenance diet.


Dogs should only be switched to a renal diet once any dehydration, nausea and vomiting has been corrected. If a dog feels sick when offered a new food, he may associate the new food with the illness and develop an aversion to it. A veterinarian familiar with the details of a dog’s case is in the best position to recommend a particular food and how best to make the transition to it.


Dr. Jennifer Coates



  1. Sanderson, S.L. Nutritional Management of Renal Disease: An Evidence-Based Approach. Today’s Veterinary Practice. 2014, Jan/Feb. 
  2. Vaden, S.L. Can We Halt Progression of Renal Disease? Presented at the British Small Animal Veterinary Congress, Raleigh, N.C. 2007.


Image: Thinkstock


Comments  8

Leave Comment
  • Sub-Q LRS
    04/11/2014 09:35pm

    Would dogs with kidney disease benefit from sub-q LRS like cats do?

  • 04/14/2014 02:38am

    Sub-Q fluids are an important part of treating both canine and feline chronic kidney disease.

  • Puppy with Parvovirus
    04/30/2014 08:17pm

    Hi recently our 5 month old puppy had Parvovirus and fortunately pushed through. I would like to find out if the kidneys can be affected due to the virus being in the digestive tract. If so would this diet help with any after effects.

  • 05/01/2014 06:56pm

    Most dogs recover from parvovirus without longterm damage to any of their organs. It is possible that the kidneys could be adversely affected, for instance if the dog's blood pressure became very low at any point, but as long as blood work and a urinalysis is normal, there would be no benefit to feeding a "kidney" diet anyway.

  • Prevention
    05/04/2014 07:41pm

    Are there any other ways except nutrition that could help to prevent chronic kidney disease? Just for interest, could a person replace a dogs kidney to prevent further infection?

  • 05/05/2014 07:30pm

    It's hard to say since there are so many potential variables at play (genetics, kidney trauma, etc.). At specific times there are things that can be done to protect the kidneys, for example maintaining adequate blood pressure with IV fluid therapy during anesthetic events, but those are relatively rare.

    Kidney transplants are possible, but still fairly experimental in dogs.

  • Kidney Disease dog food
    06/16/2014 07:58pm

    Three weeks ago my 9 year old female lab got into Advil. She was hospitalized for two nights. Other than drinking and peeing a lot more she seems perfectly fine. Her creatin levels are at 2.4. I have seen the posts about diet and am very confused. I have always fed her (68 lb. labrador) high-quality dry dog food but I can't tell if I need to switch supplemented with no-salt green beans from the grocery store. Is there a commercial food out on the market that you could recommend? I don't think I am up for cooking her meals - just trying to be realistic. Is wet better than dry so that she gets more moisture? I have tried evaluating/comparing phosphorous levels but am having a hard time understanding as each company seems to report it differently. Also, are there any supplements, homeopathic remedies that would help support her?

  • 06/16/2014 08:35pm

    I can't make specific recommendations since I'm not familiar with the details of your dog's case. Your vet is in the best position to do this. Did he or she recommend a prescription diet? If so, go with this, at least in the short term. In general, all other things being equal, canned diets are best for dogs with questionable kidney function.




Photo of Jennifer

... graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms, Vet-Speak Deciphered for the Non-Veterinarian .

Jennifer also writes short stories that focus on the strength and importance of the human-animal bond and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and pets.