Right Food for Dogs with Kidney Disease


Right Food for Dogs with Kidney Disease

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Homemade, Raw, or Store Bought: Discover the Best Dog Foods for Kidney Disease

So your vet just diagnosed your best friend with kidney disease. Your pet is not alone, 10 percent of dogs will be affected by the disease, and it’s especially evident in older dogs. While the truth is that kidney disease is a diagnosis that does not go away, the right therapeutic diet can make a big difference in your pet’s overall health. Armed with adequate information and preparation, you can help your dog live a healthy life with kidney disease, and in some cases of acute kidney failure, you may even be able to turn the prognosis around.

In this article, you’ll learn more about kidney disease and renal failure, how to spot the signs in your dog, what can lead to the disease, and the benefits of a special therapeutic diet. Discover the best types of treats to give a dog with kidney disease, how to make the switch to a renal-supportive diet, and what you need to know about proper meal prep. Experts will help you get to the bottom of common myths about renal diets for your dog.

What the Kidneys Are Responsible For

The kidneys in dogs filter blood, remove waste, regulate water and electrolyte balance, control blood pressure, produce red blood cells, and help with vitamin D metabolism. Kidney problems in dogs can lead to symptoms like increased thirst, weight loss, and changes in urine. Veterinary care is crucial for diagnosis and treatment to manage kidney issues and improve the dog's quality of life.

What Is Kidney Disease and Renal Failure?

Kidneys are the two bean-shaped vital organs that have the primary tasks of taking waste out of your blood, balancing your body fluids, and making urine. In this manner, kidneys act as your body’s filter. Kidney (renal) disease occurs when kidneys are damaged and cannot filter blood correctly. Over time, the damage accumulates and causes waste to build-up in the body, which can cause additional health problems, and eventually lead to kidney failure. In dogs, the kidneys use about 20 percent of their heart’s blood to operate. Unlike the liver, kidneys cannot rejuvenate. Some other functions of the kidneys in the body are:

  • Balancing the water level
  • Regulating the blood pressure
  • Regulating the red blood cells
  • Regulating the acid level

Chronic kidney disease (CKD) signals a gradual loss in kidney function over time, whereas acute kidney disease or kidney failure is a condition in which the kidneys suddenly lose the ability to function properly. Kidney failure means that your dog’s kidneys are not able to remove enough waste products from their body. Conditions that damage your dogs kidneys and decrease their ability to do their job lead to CKD as well. As kidney disease worsens, waste levels build-up in the blood causing the animal to feel sick. Issues with the kidneys can also lead to high blood pressure, low blood iron (anemia), bone weakening, nerve damage, and poor nutritional uptake. Your dog’s kidneys have the same function as your human kidneys. While a dog only needs one kidney to live, when one is in distress, it can lead to failure in the other.

Some causes of kidney problems, especially acute kidney disease, are easy to diagnose and treat. The onset of CKD is slower, making the causes harder to diagnose and treat. Causes of acute kidney disease in dogs are the result of eating some type of toxins such as poisonous plants, antifreeze, certain medicines, or bad foods. Accidental ingestion of pesticides or the chemicals we use to rid our houses of pests is one of the top causes of acute kidney failure. Even natural human supplements, such as vitamin D, a supplement people take to help with a lack of sunshine can be very poisonous to your dog’s organs.

Underlying illnesses may also exist that cause the flow of blood to your dog’s kidneys to decrease, create infections, or form urine blockages. One of the more surprising causes of CKD is dental disease. The bacteria from their dental disease get into their bloodstream and cause damage to their organs. Some dogs are born with poor kidneys and are never able to operate at optimum levels. Other possible causes of kidney disease and failure include autoimmune diseases, diabetes, amyloidosis, Lyme disease, cancer, severe dehydration, and trauma.

These breeds are more predisposed to kidney disease and failure:

  • Samoyed
  • Bull Terrier
  • Cairn Terrier
  • German Shepherd
  • English Cocker Spaniel

What Are the Signs of Kidney Disease and Failure in a Dog?

If you are a pet owner, it is important to be able to identify the signs of kidney disease and failure in your dog. The signs of acute kidney disease can appear suddenly and be quite grave. Acute kidney failure is a life-threatening emergency, and your pet’s recovery is dependent on the kidneys’ degree of damage, what caused the damage, and the treatment. Good treatment can often turn acute kidney failure around. Sometimes acute kidney failure becomes chronic kidney disease. However, the onset of CKD is slow and difficult to see. Providing supportive treatment can help your dog become and stay stable for a longer period of time. However, chronic kidney disease is usually irreversible.


Symptoms of Acute Kidney Failure

The top three symptoms of acute kidney failure are:

  • Loss of appetite
  • Vomiting
  • Extreme lethargy and excessive sleeping

Other symptoms of acute kidney failure include:

  • Problems or straining when urinating
  • Weakness
  • Disorientation
  • Increased or decreased thirst
  • Shivering or trembling

Symptoms of Chronic Kidney Disease

The signs and symptoms of CKD may be similar to other, often-underlying conditions such as hypertension or anemia (see below for a larger list). These symptoms may not show up until the kidneys have lost at least 70 percent of their function, and what you’ve noticed most is a change in your dog’s well-being. While all of these symptoms of CKD may not appear in every dog, here are some signs to look for:

  • Increased thirst and urination
  • Decreased appetite
  • Weight loss
  • Bad breath
  • Vomiting and diarrhea
  • Sore mouth or mouth ulcers
  • Weakness
  • Lack of energy and increased sleeping
  • Poor coat appearance
  • Depression
  • Seizures
  • Acute blindness
  • Diarrhea or constipation
  • Uncoordinated gait
  • Blood in the urine
  • Swelling of bone structure, such as in a dog’s face

The sooner you recognize the symptoms of kidney disease in your dog, the better the chance your vet has to make a diagnosis and create a treatment plan to slow down its progression.

What Are Possible Diseases or Conditions That Can Lead to Kidney Failure?

There are often underlying conditions that lead to kidney failure in dogs. These conditions are usually long-term and progressive. Kidney failure is not the predominant condition but is often an after-effect of other conditions or diseases. Sometimes, if your vet treats the underlying cause, they can also reverse the kidney distress. What you need to remember is that all the organ systems in your dog are connected, and when one organ has problems it can often lead to issues with others. These conditions or diseases are:

  • Congestive Heart Failure
  • Hyperphosphatemia
  • Liver Failure
  • Hepatic Encephalopathy
  • Acidosis
  • Anemia
  • Bone Pain/Increased Fractures
  • Uremic Crisis
  • Hypertension


Why Special Food for Dogs with Kidney Disease Can Make a Difference

The cornerstone of kidney disease treatment is fluid therapy and supportive nutrition. Your vet will most likely administer medication to your pet, but these are only to decrease some of the symptoms of the disease. Many dogs can live for years with kidney disease if it’s caught early and treated appropriately.

Often your vet will teach you how to perfusion fluid therapy under the skin with an IV; something that you can do at home. Sometimes, to protect your dog from the effects of low electrolytes, your vet will add potassium to the fluid or the diet. Electrolytes are the substances in living cells that help the body conduct electricity. These include sodium, potassium, calcium, magnesium, and phosphates. Electrolytes can get dangerously low when a pet is dehydrated, causing further dehydration and organ damage.

Supportive nutrition for dogs diagnosed with kidney disease includes foods with reduced levels of phosphorus and sodium and increased levels of omega-3 fatty acid. Additionally, the quality of the protein that you feed your dog is critical for their disease management and overall well-being.

Controversy exists in the dog food market and among veterinarians about high- versus low-protein diets for dogs. The current recommendations have only come within the last five years, so ensure that any resources you use for guidance are from this timeframe. Many vets recommend feeding a low-protein diet (that consists of high-quality protein) to your dog diagnosed with kidney disease. This recommendation comes from studies of rats, with minimal evidence to support this theory in either people or dogs. Some vets may also recommend a low-protein diet as a way to resolve other medical problems historically associated with kidney disease, but a low-protein diet may not be the best choice. With kidney disease, your dog needs to have perfusion (movement of fluids through organs, such as blood) so that toxic wastes have a better chance to filter out of the body. Low protein diets decrease the perfusion of the blood flow through the kidneys. With decreased circulation, there is an increase in kidney cell death which is what causes the signs and symptoms of kidney disease.

Therefore, you want to feed high-quality protein to your dog with kidney disease. However, the quality of the protein is critical and can vary in pet food. There are proteins that your dog’s body can absorb easily, such as raw meats, rice, or eggs. Similarly, there are proteins that have been dehydrated or processed that your dog can’t digest at all. Further, some sources of protein (like soy protein) are not appropriate for your dog. Soy protein has little to no biological value for your pet, but it’s an inexpensive way for manufacturers to ensure protein content on their labels. It may even cause metabolic stress on your pet, especially if you feed him dehydrated or processed food. Processed and dehydrated protein is hard on your dog’s body. As your dog ages, they need more protein. Kidney disease is rarely a young dog’s diagnosis.

Dogs do have a natural tendency towards eating meat. Many scientists and experts also fight over whether dogs are natural omnivores, meaning they eat both meats and grains, or carnivores, meaning they only eat meat. Looking at the canine skull, there are sharp, pointy teeth that evolved to bite and tear flesh, and flat teeth that grind up plant matter. However, if you look at their closest ancestor, the wolf, you see a predominantly meat-eating creature with four to seven percent of their diet consisting of plant matter. Kibble consists of between 30-60 percent plant matter, making it an inappropriate diet choice by these standards.

Some experts also say the diet you feed your dog should be dependent on your dog’s stage of renal disease. In the early stages of kidney disease (Stage 1 and Stage 2), experts recommend feeding your dog high quality, easily digestible food. In the later stages, of kidney failure, that’s when you need to decrease the protein level. Vets often suggest this diet change once they find protein in a dog’s urine, which can make it harder for your dog’s kidneys to digest the highest levels of protein. However, if you have your dog on dialysis, you must increase their protein intake, as dialysis removes protein waste and proteins from the blood. Before making any diet changes at any of these stages, first talk to your vet and get a specific recommendation suited to your dog’s needs.

What Should a Kidney Dog Food Diet Entail?

You may be wondering what you should feed your dog specifically and whether you should make your dog’s food or look for a commercially made brand. There is certainly more control when you make your dog’s food in your kitchen since you know exactly what your dog is eating (aside from what he gets in the yard when you are not looking). However, there are some commercial diets that could work as well. Whether you plan to feed your dog a homemade diet or use commercial food, it’s imperative that the food meets their dietary needs. For dogs with renal health issues, feed them a diet of high-quality protein with low phosphorus and sodium, and added omega-3 fatty acids, such as a mix of good quality meat, veggies like bell peppers, and either a supplement of omega-3’s or fish, flax, sardines, or anchovies. You want a good variety of protein, ideally raw. Avoid kibble, also known as dry food because it can cause dehydration. Making your own best dog food can be time and labor intensive, but if you do make it follow a formula so that you do not overlook any crucial ingredients. To provide a complete and balanced diet, in addition to the primary food components, there are additional nutrients that need to be added. Providing those nutrients in the right quantities and an effective manner can be difficult to do at home.

Some principles to remember on this diet are that you can and should adjust it based on what is available, especially over the course of a week. A “balanced” diet is the subject of much speculation and debate in the veterinary community. The basic recommendation over the course of the week is:

  • 12-15% meaty bone
  • 10-30% organ meat
  • 30-50% muscle meat
  • 5% fish

Additionally, keep extra fats low, starch non-existent, and above all, offer your dog variety. Fish is always a good idea, but only once or twice per week.

Commercial diets can be fine for your dog with kidney disease, as long as you find food that can meet their dietary needs. Unfortunately, most foods at pet stores will be too high in phosphorus to produce the desired effect. As kidney disease progresses, your dog will need to have lower levels of phosphorus. Food with high moisture content is critical for your dog’s renal diet. Raw diets, that feature high-quality protein, are the gold standard. There are raw dog foods that you can purchase commercially.

The characteristics you may see listed on commercial dog food include:

  • Organic: These foods do not have exposure to preservatives, pesticides, fertilizers, genetically modified organisms, or ionizing radiation. If it is meat, the animal is not given antibiotics or growth hormones. This distinction is important in kidney diets because it means the food has no toxins, putting less of a strain on your pet’s current organ function.
  • Phosphorous to Calcium Ratio: Phosphorous should be low, as it is thought to slow the progression of kidney disease; low rates of phosphorus increase the rates of survival. The calcium should be higher than the phosphorus.
  • Fresh Food: Fresh food really refers to how bioavailable it is for your dog. In other words, if the food is easily digestible, it provides the most nutrition.
  • Raw Food Diet: Also known as the Biologically Appropriate Raw Food (BARF) diet (bones and raw food), a raw food diet consists of uncooked meats and additives such as fruits, vegetables, sometimes grains, and a mix of supplements.
  • No Kibble: As discussed above, kibble is a bad idea for dogs with kidney disease. It further dehydrates a dog that is already dehydrated.
  • Canned: Canned food is certainly a better choice than kibble when feeding your dog with kidney disease. It has more moisture, but would also have preservatives such as salt to help keep it fresh in the can. These are not ideal for your dog. Canned food must undergo heat processes, which causes losses of certain vitamins.
  • Decreased Sodium: High sodium diets increase blood pressure and worsen any kidney damage, so low sodium diets are best.
  • Increased Omega-3 Fatty Acids: Omega-3 fatty acids help reduce inflammation and reduce hypertension in parts of the kidney. They also help improve kidney function.
  • Increased B-Vitamins: Increasing B-vitamins in your dog’s food compensate for those lost in their urine. B-vitamins are water-soluble and are lost more quickly in diseased kidneys.
  • Added Antioxidants: Antioxidants help with cellular damage and boost the immune system.
  • Decreased Phosphorus: As discussed above, reduced phosphorus can improve renal function and increase longevity in dogs with kidney disease.
  • Dietary Fat/Calories: Excessive fat in your dog’s food can put a strain on the kidney. However, your dog can tolerate higher levels of fat in their food when they have kidney disease, so it may be a good way to add some calories to their diet.
  • Reduce Nitrogenous Waste/By-Products: Urea, creatinine, and other body wastes often cause high levels of nitrogen in the blood. Uremia is a condition that is due to improper excretion of the waste products. Nitrogen can become present in these high levels because of improper filtration of the kidneys. In other words, nitrogen levels increase and are able to be found in the blood when the kidney is in late-stage failure. This is the stage when proteins should be reduced to decrease the nitrogenous by-products.
  • Potassium Citrate: This supplement raises the blood bicarbonate concentration when it is tested low in all stages of renal disease. The blood bicarbonate level goes down in your dog’s blood because of the impaired kidney function making their blood more acidic.

For a dog with kidney disease, however, quality commercial dog food should consist of the following:

  • Animal Protein
  • Whole Fruits and Vegetables
  • Fresh
  • Moisture Content between 80 -85%
  • Easily Digestible Proteins

Your dog’s food should also meet the standards set by The Association of American Feed Control Officials (AAFCO), which regulates the sale and distribution of food and drugs for animals.

How to Switch Your Dog to a Renal-Supportive Diet

Picky dogs can be difficult to feed. Dogs who are not feeling well, and those with renal disease, often don’t want to eat. In fact, this is often one of the first symptoms of the disease. So how do you get them the nutrition they need when they do not want to eat? Whether you are switching over to something completely new, or just supplementing their regular food, you want to start by introducing the new nutrition slowly. Gradually mix the new food or supplement it with their current food. Then increase the kidney diet food and reduce the existing food each day until it is the only food they are getting. Fortunately, nutritionists design most renal diet foods to be very palatable. Other ways to help get your dog with kidney disease interested in eating again:

  • Give them their medication separately from their food. This goes a long way in ensuring that they do not negatively associate feeding time with bad-tasting medicine time.
  • Create a comforting environment for eating time. If this means you sit on the floor and stroke them while they eat at home, then so be it.
  • Try a different renal-support recipe or a yummy additive if they still will not eat. The earlier you can get them to adapt to new food, the less damage they will have from renal breakdown.

Vitamins, Supplements, and Treats for Dogs with Kidney Disease

Aside from supportive nutrition and any medications that your vet prescribes your dog, there are some additional measures to consider. First, due to the nature of renal disease, your dog is losing some of their vitamins through their increase in urination, which can lead to the depletion of nutrients, especially the water-soluble ones, and malnutrition. This is why a normal diet is not adequate, and your dog must go on a special diet that increases the nutrients needed and compensates for their loss.

Dog treats are another source of extra nutrition. Avoid treats with excess sugar or propylene glycol. Experts do not expressly forbid these ingredients and they will not harm your dog, but they will not help with its health. Good occasional treats include carrots and green beans. Both of which are low calorie and high fiber. Make sure that before you choose fruits or vegetables, you know the effect they will have on your dog. For example, dogs should not have grapes, raisins, coconut, avocado, citrus, onions, and garlic. These are toxic to dogs and could cause kidney failure.


Commercially available supplements for dogs with kidney disease are also an option. Look for ones that include vitamin E, zinc, S-Adenosylmethionine (SAM-e), milk thistle, and ursodiol. Commercial companies produce Denamarin and Denosyl (labeled as kidney mixes containing SAM-e and Silybin) as supplements for pets. SAM-e is used to replace the amino acids lost due to kidney disease, and Silybin is an extract of milk thistle thought to work as an antioxidant and an anti-inflammatory.

Meal Preparation for Dogs with Kidney Disease

Regardless of the food that you and your vet choose, the most challenging part will still be to get your dog to continue eating regularly. Consider increasing the amount of times you feed your dog since those with kidney disease struggle to maintain their weight. Their appetite will invariably go down, so it is up to you to try different options to see what will work.

Most critical is their access to fresh water. Many experts recommend, if possible, that you ensure the water your pet has is fresh and free of contaminants. Filtered water is best because it removes all contaminants. Whether you end up filling your pet’s bowl several times per day from your filtered tap or acquiring a pet water fountain, explore what works for you. One point about pet water fountains: they provide a stream of fresh, filtered water for your pet, but need to have their filter changed regularly.

As discussed earlier, you should feed your dog slightly differently, depending on their stage of the disease. These are the stages BEFORE your vet finds protein in your dog’s urine. For the early stages of kidney disease, your goal is to stave off additional damage and compensate for increased urination. If you are cooking at home for your dog, remember that a high moisture level is critical in a renal diet. Check with your vet to adjust the quantities depending on your dog’s weight and size. For most dogs, you are looking to feed them about two to three percent of their body weight. As your dog’s disease progresses (protein increases in their urine), you need to reduce the amount of meat to reduce their level of phosphorus. Consider using supplements such as adding those listed above, in approved levels for your dog’s weight.

If you look for pet food recipes for kidney disease, look for ones that have been created within the last five years. There are resources on the internet that have not gotten up to speed on the current research and recommendations. Use the guidelines above and your best judgment when preparing your dog’s food. One good resource that adheres to these current recommendations is Raw and Natural Nutrition for Dogs, Revised Edition: The Definitive Guide to Homemade Meals.

For dogs in later stages of the disease, another great recipe and supportive source that adheres to the current research is from Dale Schierbeck of Eats Writes Shoots, 2017.

More About Protein and Kidney Disease Dog Food

There are several medical diagnoses that may make you want to put your dog on a low-protein diet. Protein is a large, complex molecule that can be difficult for the organs to break down. Protein breaks down into amino acids that your dog’s body absolutely needs. However, in certain conditions, you want to lower, but not eliminate, the protein your dog gets because of its complexity. For example, dogs with kidney failure already have reduced kidney function, causing their kidneys to become overwhelmed by too much nitrogenous waste from digesting protein. At this point, excess protein waste products are toxic. The more protein your dog’s kidneys get, the harder they must work, and eventually, they are unable to keep up and may fail even further.

Other conditions that need a low-protein diet include the following:

  • Glomerulonephritis: This is a type of kidney disease where the glomerulus in the kidney is inflamed.
  • Lyme-disease associated nephritis: This disease spreads through infected ticks.
  • Portosystemic shunt (liver shunt): Staying on a low-protein diet is necessary because the blood bypasses the liver so that toxins can build up in the bloodstream or kidneys.
  • Hepatic encephalopathy: In this condition, the byproducts of protein digestion develop the disease symptoms.
  • Urinary stones: A low-protein diet for stones should only be temporary. One protein waste product is urea, which is also a building block for ammonia which creates stones. Going low-protein to help dissolve stones is okay for a short time, but your dog needs the nutrition the rest of the time.
  • Congestive heart failure: In this condition, experts only recommend a low-protein diet if it is coupled with kidney failure.

Feed Your Dog an Intelligent Design™ Prescription Meal for Dogs

At Darwin’s Pet Products, our number one goal is to help keep your pets healthy and active for as long as possible. That’s why we’ve worked with leading veterinarians to develop a diet specifically to meet the nutritional needs of dogs with kidney disease. With Darwin’s Intelligent Design™ KS Kidney Support for Dog, including prescription diets, you can rest assured that you’re serving your pet the best possible combination of proteins, calcium, vitamin B, and Omega-3 fatty acids to aid in managing their disease. We produce affordable, high-quality raw dog and cat meals which we ship directly to consumers so they are as fresh and convenient as possible. Our meals are high in protein, gluten-free and wheat free, and are created to provide complete and balanced nutrition. We also provide a library of articles in the hope of providing consumers with useful information to help their pets.

We encourage you to learn more about our meals for dogs and meals for cats. If you think you might want a trial of Darwin’s  (at an introductory price), we would love to send you our meals and hear how much your dog or cat loves them.

Frequently Asked Questions

Can I feed my dog with kidney disease a combination of the best commercial and homemade foods?

Pet owners often wonder if it's possible to create a balanced diet for their dogs with kidney disease by combining the best commercial renal diets with homemade dog food.

Are there any alternative protein sources besides high-quality meat that can be included in a kidney-friendly diet for dogs?

Some pet owners may want to explore protein alternatives for their dogs, such as plant-based options or novel protein sources, and their suitability for kidney problem management.

How can I monitor my dog's progress and adjust their diet as kidney disease advances, considering the benefits of omega-3 fatty acids?

Pet owners may seek guidance on how to track their dog's condition over time, make necessary adjustments to their diet as the kidney problem advances, and incorporate omega-3 fatty acids for added benefits.

What role do treats enriched with omega-3 fatty acids play in a kidney-friendly diet for dogs, and are there specific treats recommended for these pets?

Many dog owners like to offer treats to their pets, and they may want to know if there are suitable treat options enriched with omega-3 fatty acids that align with a kidney-friendly diet.

Is it essential to consult with a veterinary nutritionist when planning a specialized diet for a dog with kidney disease, including the consideration of prescription dog food?

Some pet owners may consider seeking the expertise of a veterinary nutritionist to develop a customized diet plan for their dog with kidney disease, and they may have questions about the importance of this step, including the use of prescription dog food in renal diets.


  1. https://vcahospitals.com/know-your-pet/nutrition-for-dogs-with-chronic-kidney-disease
  2. https://www.petmd.com/dog/nutrition/what-feed-dog-kidney-disease
  3. https://www.dogsnaturallymagazine.com/canine-diets-for-kidney-failure/
  4. https://drgoodvet.com/pet_health/homemade-dog-food-for-kidney-disease/
  5. https://www.poochandmutt.co.uk/blogs/health/what-food-is-best-for-dogs-with-kidney-disease

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