diet for dogs with early kidney disease

By Isabella Storyclaire

last updated September 16, 2024

Contributions sourced from

Dietary Guidelines for Dogs with Chronic Kidney Disease (CKD)

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Nutrition and Early Kidney Disease (Stages 14)

Kidney-friendly nutrition & COVID-19

Why is good nutrition important for people with kidney disease?

Making healthy food choices is important to us all, but it is even more essential if you have kidney disease (CKD). Good nutrition helps:

Provide energy to do your daily tasks
Prevent infection
Avoid muscle-mass loss
Help maintain a healthy weight
Slow down the progression of kidney disease

What are the basics of good nutrition?

A well-balanced diet gives you the right amounts of protein, calories, vitamins, and minerals each day. Eating a healthy diet, staying physically active, and taking all your medicines as prescribed are all important parts to keeping you healthy and feeling well.

Will I need to change my diet if I have kidney disease?

Your kidneys help keep the right balance of nutrients and minerals in your body. But if you have kidney disease, your kidneys may not do this job very well. You may need to make some changes to your diet.

Registered dietitians and kidney disease

Ask your doctor about meeting with a Registered Dietitian with special training in kidney disease. A dietitian can:

Teach you to make the best food choices based on your lifestyle and lab tests
Make changes in your diet to help you better control diabetes and high blood pressure
Help you to keep your kidney disease from getting worse

Meeting with a dietitian is a covered service by Medicare and may also be covered by other types of insurance. You may need to call your insurance provider to determine if your plan covers meeting with a dietitian.

Are you looking for nutrition guidance? Contact a CKD dietitian in your area.

What kinds of changes will I need to make to my diet?

There is no one correct eating plan for everyone with kidney disease. What you can or cannot eat may change over time, depending on your kidney function and other factors. If you are following a special diet for diabetes or heart conditions, you will need to continue following it.

What will I need to control in my diet?

People with kidney disease may need to control the amount of:

Protein
Sodium
Potassium
Phosphorus
Calcium

Eating the right amount may help control the buildup of waste and fluid in your blood. This means your kidneys do not have to work as hard to remove the extra waste and fluid. If your kidney disease gets worse, you may need to limit other nutrients as well. Your dietitian or healthcare provider will tell you if you need to do this based on your blood test results.

Protein

Your body needs protein to help build muscle, repair tissue, and fight infection. If you have kidney disease, you may need to watch how much protein you eat. Having too much protein can cause waste to build up in your blood, and your kidneys may not be able to remove all the extra waste. If protein intake is too low, however, it may cause other problems so it is essential to eat the right amount each day.

The amount of protein you need is based on:

your body size
your kidney problem
the amount of protein in your urine

Your dietitian or healthcare provider can tell you how much protein you should eat.

Sodium

Healthy kidneys control how much sodium is in your body. If your kidneys do not work well, too much sodium can cause fluid buildup, swelling, higher blood pressure, and strain on your heart. Your dietitian or healthcare provider can tell you the right amount of sodium you should have each day.

Potassium

Potassium works with the muscles, including the heart. Too much or too little potassium in the blood can be very dangerous. The amount of potassium you need is based on how well your kidneys are working and your medications. Your dietitian or healthcare provider can tell you about foods with potassium and the right amount for you to eat each day.

Phosphorus

As kidney function gets lower, extra phosphorus can start building up in the blood. High phosphorus levels can cause bones to get weaker. Your dietitian or healthcare provider can tell you if you need to limit goods that are high in phosphorus.

Calcium

Foods that are good sources of calcium are often high in phosphorus. Your dietitian or healthcare provider will tell you if you need to limit calcium. Before taking any over-the-counter vitamin D or calcium supplements, talk to your healthcare provider.

Will I need to limit fluid?

Most people in the early stages of kidney disease do not need to limit how much fluids they drink. If you do not know your stage of kidney disease, ask your healthcare provider. If your kidney disease worsens, your dietitian or healthcare provider can let you know if you need to limit fluids and how much to drink each day.

How many calories do I need?

Every person is different. Calories are like fuel. If you dont eat enough, your body will take protein from the muscles for energy. Its important to make sure you get the right amount of calories or you may get weak and cause damage to the kidneys. Eating the proper amount of calories will:

Help you stay at a healthy weight
Give you the energy to do your daily tasks
Help your body use the protein in food to build muscle and tissues

Too many calories can cause extra weight gain, which can burden the kidney. If you are overweight, some weight loss may be beneficial. If weight loss is desired or you have diabetes, you should meet with a dietitian to set up a plan based on your kidney blood tests, current food choices, and daily activities.

Should I be taking any vitamin and mineral supplements?

Most people get enough vitamins and minerals to stay healthy by eating various foods each day, but kidney patients may need to limit these foods. If so, you may need to take special vitamins or minerals but only if a dietitian or healthcare provider tells you to. Some may be harmful to people with kidney disease.

You should check with your healthcare provider before taking any medications you can buy without a prescription. Some over-the-counter medications may be harmful to people with kidney disease. You should also avoid taking herbal supplements.

Last Reviewed: 09/08/2023

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What To Feed a Dog With Kidney Disease

Nutrition plays a big role in the management of dogs with kidney disease. Because dogs with kidney disease usually arent feeling well, the first step is often to merely get your dog to eat anything.

Kidney disease can make dogs nauseated, and they can also develop ulcers in their mouth or stomach, which makes eating painful. A feeding tube may be necessary to get dogs with severe kidney disease the nutrition they need.

Once your dogs condition is more stable, you can turn your attention to providing more optimized nutrition. Kidney diets for dogs have to tick a lot of boxes. Heres a guide that explains nutritional needs and what to feed a dog with kidney disease.

What To Look For in a Kidney Diet for Dogs

Kidney diets for dogs are significantly different from regular dog foods. However, no single kidney diet is going to be best for every dog throughout the rest of their life.

For example, a dog in the early stages of kidney disease could thrive on a kidney diet with more protein, but as their disease progresses, a diet lower in protein and phosphorus might better control their symptoms.

As a rule of thumb, good kidney diets for dogs tend to have anutrient profilethat looks like this:

Nutrient	Grams/1000 kcal
Protein	31-41
Phosphorus	0.5-0.8
Sodium	0.4-1.2
EPA and DHA	0.4-1.2

Unfortunately, it can be hard tofind this information on dog food labelsor on pet food manufacturers websites. If you are having trouble getting the numbers, your veterinarian can help you pick a good kidney diet based on your dogs needs.

Here are several important elements to look for in kidney diets for dogs:

Taste

The most important characteristic of a kidney diet for dogs can be the hardest to achieve: It has to be delicious! Thats because the metabolic and physical changes associated with kidney disease can lessen a dogs appetite.

To counteract this effect, kidney diets need to smell and taste great. After all, a kidney diet that isnt eaten isnt going to do a dog any good. Kidney diets should also be calorie- and nutrient-dense, so dogs can eat less and still get a lot of nutrition.

Hydration and Water Content

Kidney diets should also contain a lot of water. Dogs with kidney disease struggle to maintain their hydration. All dogs always need to have access to bowls of fresh clean water, but a diet that has high water content is a great way to boost a pets water intake when they have kidney disease.

Wet foods are almost always a better option for dogs with kidney disease than dry foods. If you are feeding your dog kibble, ask your veterinarian about adding water to the dry food or other ways you can supplement their water intake.

It's also important to keep an eye on the sodium levels in kidney diets for dogs. Too much sodium increases the chances that your dog will becomedehydrated.

The Right Amount of the Right Protein

Next comes the balancing act that is protein. Dogs with kidney disease need protein, but not too much. The breakdown products of protein digestion are responsible, in large part, for making dogs with kidney disease feel yucky.

The goal is to feed just enough protein to meet a dogs needs for muscle maintenance, immune function, and the other vital jobs proteins have in the bodybut not to feed too much more. Extra protein will only be turned into calories that can be more safely provided by carbohydrates and fats.

Protein quality is also important. Proteins should be highly digestible and supply all the essential amino acids dogs need.

Low Phosphorus Levels

Theres a close relationship between protein intake and blood phosphorus levels. Dogs with kidney disease gradually lose the ability to excrete phosphorus in their urine, so it backs up in the bloodstream. Reducing phosphorus intake has been shown to slow the progression of kidney disease in dogs and increase their lifespan.

An important way to reduce phosphorus levels in the diets of dogs with kidney disease is to not overfeed protein and to ensure thatproteins relatively low in phosphorusare included in the diet. Plant-based sources of protein tend to be lower in phosphorus than animal-based sources of protein.

Supplements

Nutritional supplements can also help dogs with kidney disease. Supplements often included in kidney diets for dogs include:

Omega-3fatty acids:eicosapentaenoicacid (EPA) and docosahexaenoic acid (DHA), which can reduce inflammation in the bodyincluding in the kidneysand possibly improve kidney function
Antioxidants,which neutralize free radicals that can further damage the kidneys
Fermentable fiber,which helps get rid of protein digestion waste products in poop. This allows dogs to eat more protein than they might be able to otherwise.

Prescription Kidney Diets vs. Homemade Kidney Diets for Dogs

What abouthomemade kidney diets for dogs? Astudypublished in 2012 showed how hard it is to find nutritionally complete and balanced kidney diet recipes in books and online. Of the 39 recipes evaluated, none met all the National Research Councils recommended nutrient allowances for adult dogs.

In contrast, prescription kidney diets produced by reputable dog food manufacturers undergo testing to ensure they are safe for long-term feeding and have a positive effect on a dogs health.

How To Cook for Dogs With Kidney Disease

One big benefit of homemade kidney diets, however, is taste. If your dog simply wont eat anything else, a homemade kidney diet is worth considering. To avoid nutrient deficiencies or excesses, make sure a veterinary nutritionist or a service likeBalanceIT, which requires veterinarian approval, is involved in formulating recipes for your dog.

Common Prescription Kidney Diets for Dogs

After a dog has been diagnosed with kidney disease and their condition is stabilized, veterinarians typically recommend switching over to a prescription kidney diet. Your veterinarian may have recommended a particular food based on the details of your dogs case. Here are three popular options:

Hill's Prescription Diet k/d Kidney Careis available in wet and dry formulations and different flavors:

How To Transition Your Dog to a Kidney Diet

special attention to how you make the transition. Do notchange your dogs foodwhile they are still nauseated or feeling bad. They may associate their symptoms with their new food and refuse to eat it.

Once your dog has a good appetite, start making the switch very slowly. Give them lots of time to get used to the new flavors, textures, and ingredients. This reduces the chance of food refusal and lets your dogs digestive system adapt.

Here is a timetable for taking two weeks to switch your dog to a new diet:

Days 1 and 2:Mix 5% of the new food in with 95% of the old food
Days 3 and 4:Mix 10% of the new food in with 90% of the old food
Days 5 and 6:Mix 20% of the new food in with 80% of the old food
Days 7 and 8:Mix 40% of the new food in with 60% of the old food
Days 9 and 10:Mix 60% of the new food in with 40% of the old food
Days 11 and 12:Mix 80% of the new food in with 20% of the old food
Days 13 and 14:Mix 90% of the new food in with 10% of the old food
Day 15:Try 100% of the new food

If at any point your dog turns their nose up at their food or develops signs of digestive upset, move back a step in the timetable and proceed more slowly.

Signs to Watch for After Starting Your Dog on a Kidney Diet

Dont give up if you initially have trouble switching your dog to a kidney diet. Call your veterinarian if your dog wont eat the recommended food. They can help by:

Recommending an appropriate food topper to make the food more appealing. Avoid products that are high in phosphorus and salt.
Prescribing medications to reduce nausea, stomach inflammation, ulcers, or other symptoms that may be reducing your dogs appetite
Recommending a different prescription kidney diet or, if necessary, a suitable over-the-counter food
Referring you to a veterinary nutritionist to get recipes for homemade kidney diets
Talking to you about the benefits of a feeding tube

Many dogs with kidney disease live happily for quite a long time, particularly if they get the right kind of nutrition. Onestudyshowed that on average, dogs who were fed a kidney diet lived 13 months longer than those who ate regular dog food. Thats certainly a goal worth striving for!

Featured image: iStock.com/RichLegg

WRITTEN BY

Jennifer Coates, DVM

Veterinarian

Dr. Jennifer Coates is an accomplished veterinarian, writer, editor, and consultant with years of experience in the fields of veterinary...