Recently updated on May 16th, 2024

How to Feed a Dog with Kidney Disease, Naturally

Kidney disease, also known as renal disease, is any condition that causes damage to the kidneys. When the kidneys cannot function properly, the result can be life-threatening. While typically irreversible, you can help your dog manage the disease by feeding your dog the proper diet. Knowing what food are good for dogs with kidney disease can be of the utmost importance. Feeding your dog a diet complete with the proper nutritional support will help slow the progression of your dog’s kidney disease and improve their quality of life.

The Canine Kidney

The kidneys perform many key functions for the canine body including the following:

Functions of the canine liver
  • Removal and excretion of metabolic waste and water preventing waste build up in the blood.
  • Regulate ions such as calcium and phosphorus, which helps in the regulation of bone mineral metabolism as well as prevent seizures, arrythmias and respiratory problems.
  • Regulation of red blood cell production by releasing a hormone called erythropoietin(ERO), which stimulates the production in the bone marrow.
  • Help to maintain the correct acid-base balance of the blood, or blood pH.
  • Maintain and balance of electrolytes, including sodium and potassium which regulate blood pressure.
Renin Calcitrol Erythropoietin canine hormones

Clinical Signs of Canine Kidney Disease

A complete urinalysis and a blood chemistry analysis are used to diagnose canine kidney disease. While some dogs may show early signs of kidney disease, most do not show signs until approximately 75% of their kidney function is lost. For this reason, early detection of the disease is incredibly important.

Because early detection is so important, if you notice any of the following symptoms from your dog, kidney problems may be the cause and you should visit your Veterinarian for testing:

  • Weight loss
  • Physical weakness
  • Increased thirst and urine production
  • Blood in urine
  • Decreased appetite
  • Bad breath or mouth ulcers
  • Vomiting or diarrhea
  • Poor coat
  • Lethargy
  • Loss of interest in play
  • Urinary tract infections
  • Anemia
symptoms of canine liver disease

Check out “Recognizing The Signs & Symptoms of Kidney Disease in Dogs” for more detailed information.

The Importance of Diet in Managing Kidney Disease

If your dog has been diagnosed with kidney disease, there are some things you can do to help them feel better and improve their quality of life. One of the most important things you can do is to make sure they are getting the proper nutrition. If you follow these nutritional guidelines, you can help your dog live a comfortable life despite their kidney disease.

It is also important to monitor the canine liver function as well as the pancreas function as they all rely greatly on one another.

Please Note: It is important to consult with your Veterinarian, regarding what to feed a dog with kidney disease, using the results of your dog’s urinalysis and bloodwork, together you can decide on the best nutritional support. Ensure to have your pet retested every 3-6 months, and adjust as needed.

Types of Canine Kidney Disease Diets

Feeding a dog with kidney disease with, even a high-quality, commercial dog food that is not specifically designed to support the kidneys can be dangerous. Kidney disease requires specific nutritional support. So what are your options? It really comes down to 3 options; a prescription commercial dog food, a fresh delivery subscription dog food specifically designed for renal support, or a homemade diet. There are pros and cons to each of those options.

In this article we will also give our top recommendations as well as recipes for each of the options. It is important to make sure you consult your Veterinarian. By using current bloodwork, you can optimize the very best nutritional support with the advice of your Veterinarian or Canine Nutritionist.

Hydration & Moisture Content

Just like humans, dogs with kidney disease need to stay hydrated. While having access to plenty of fresh, clean water at all times is extremely important for dogs with kidney disease, you can also help keep your pet hydrated through their food. Rather than feeding kibble that has a moisture content of around 10-15% on average, choose fresh whole food ingredients with as much as 85% moisture. If that is not an option, opt for canned food.

Nutrient Profile of Kidney Disease Diet

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Renal Diet For Dogs Nutrient Profile

High Quality, Digestible Protein

A controversial subject in the treatment of kidney disease is the amount of portent. More recent studies have found that more important than whether the diet restricts protein intake or not is ensuring that protein intake is high quality. In addition, a protein deficiency may cause or worsen existing anemia, hypoalbuminemia, poor coat, and loss of muscle mass.

Fresh, whole food proteins rather than processed portions such as in kibble and other manufactured diets provide a more positive impact on health and will help your dog maintain muscle mass. Look for highly digestible, with a high biological value, proteins. High-quality proteins will also decrease the workload on the kidneys as they have less protein waste to process. Aim for protein levels of 15% Dry Mass.

High Quality, Digestible Sources of Protein:

  • Eggs
  • Chicken
  • Fish
  • Quinoa
  • Dairy
  • Soy

Note: Cooking the protein lowers the digestibility because it exposes the enzymes to heat. Feed whole foods raw for best results.

Restrict Phosphate Intake

One of the jobs of the kidney is to remove phosphorous from the body. With impaired kidneys, phosphorous begins to accumulate in the blood. The increase in phosphorous stimulates the parathyroid gland to increase blood calcium, which it does by removing calcium from the bones. This contributes to brittle bones as well as to lethargy and poor appetite. Limiting phosphate intake along with a limited protein intake has been shown to limit the progression of kidney disease.

The goal phosphorus level defined by the International Renal Interest Society is between 2.5 and 4.6 mg/dl for earlier renal insufficiency stages, and to keep in under 6 for Stage 4 (more advanced) patients(1).

A phosphate binder can also be used to bind phosphate and help prevent excess from being absorbed into the bloodstream and lowering the blood levels of phosphorus.

Adequate Calcium and Vitamin D

As mentioned above, excess phosphate can cause calcium to be removed from the bones. To ensure a dog with kidney disease does not incur musculoskeletal disorders, it is important to ensure they have an adequate amount of both calcium and vitamin D.

Vets will often recommend Calcitriol, which is the active form of Vitamin D, which is the hormone that helps your dog absorb calcium. Calcitriol has been proven to effectively reduce renal failure. Veterinarians recommend this supplement as it does not have any negative side effects.

Restrict Sodium Intake

Dogs with renal disease cannot tolerate excessively high or low sodium intake. In fact, Hypertension in dogs with renal disease is estimated to be 58-93%. Aim for sodium intake for dogs with renal disease to be .1-.25% DM (5-30 mg/kg q 24 HR)

Include Kidneys or Organs

Organ meat, particularly kidneys can help support the kidney itself. Organ meats and glands are an essential source of proteins, peptides, enzymes, and cofactors for our canine family members. If you can not easily get actual organs and kidneys to feed your dog, or you do not want to deal with the mess, use a Glandular supplement that contains kidneys and other organs. I highly recommend the company Standard Process, for their organ-based supplements.


Canine Renal Support

Canine Renal Support

Add this for even greater support.

supporting kidney function in dogs


Include Omega-6:Omega-3 Fatty Acids at 5:1

There is evidence that supplements with omega-6 polyunsaturated fatty acids and omega-3 PUFA provide a benefit to dogs with kidney disease. The optimal ratio for these is 5:1. Be sure you are using whole-body fish oil rather than cod liver oil.


Omega Fatty Acids For Dog Kidney Disease

Wild Alaskan Salmon Oil

Kidney Support Supplements

These natural supplements provide nutritional support with added benefits to help aid in supporting the canine kidney.


dog kidney disease supplement

RX Renal Canine

Prescription Dog Food For Dogs With Kidney Disease

There are special dog foods available that are designed for dogs with kidney disease. These are some of the ones we recommended for dogs with kidney disease.

Non-Prescription Vet-Approved Dog Food For Dogs With Kidney Disease

These foods are non-prescription, however, they are vet approved and meet all the requirements as a good food for kidney-diseased dogs.

Ship to Home Whole Food Diets

If you are looking for the most healthy option for a diet for your dog but do not have the time to actually prepare their meal from scratch at home, a great solution is a ship to your home, whole food dog food. I highly recommend Spot and Tango.

Homemade Dog Food For Dogs With Kidney Disease

Before putting your dog with kidney disease on a homemade diet, it is important that you not only have researched the requirements of a balanced diet for a renal patient but also that you know your pet’s own vitals and bloodwork. Only then, and with the guidance of your veterinarian or a canine nutritionist, should you feed your dog a homemade diet if they have kidney disease. If you do, meet those criteria and move forward with a homemade diet, your dog will be thankful, as they likely will have far better results than with any other options.

Here are 3 vet approved homemade dog food recipes for dogs with kidney disease:

Tilapia Fried Rice For Dogs
A highly digestible fish protein with plenty of omega fatty acids, low phosphorus and low sodium
Check out this recipe
homemade tilapia fried rice dog food
Egg Based Homemade Dog Food
Egg is the base of this recipe and they are a great source of highly digestible protein that also is an excellent source of omega fatty acids.
Check out this recipe
egg based homemade dog food
Ground Turkey and Quinoa Dog Food
Turkey and quinoa both provide highly digestible proteins in this food designed for dogs with kidney disease.
Check out this recipe
Turkey and quinoa homemade dog food

Check out our other Great Vet Approved Homemade Dog Food Recipes for additional options.

Additional Considerations For Feeding Dogs With Kidney Disease

Neutral pH

Most commercial dog foods are designed to be acidifying, causing pets with kidney disease to become too acidic. It is important to counteract this issue by providing a diet specifically designed to be non-acidifying.


Finally, make sure your dog is getting plenty of exercise. Walking and playing are great ways to help them stay active, while also promoting kidney function.

Small Frequent Meals

Feeding your dog small, frequent meals throughout the day is also important. This help to prevent them from becoming nauseous or experiencing an upset stomach.

Rotate Diet

Dogs with kidney disease tend to become more averse to food as the disease progresses. In order to keep the dog interested in eating, which is extremely important, rotate among 3 or 4 recipes.

Stage of Disease

The stage of kidney disease is also an important factor in how you manage it. For Chronic Renal Failure, check out this article on Chronic Kidney Failure.

For more information on the evidence behind these nutrient, alterations read this article in Today’s Veterinary Practice.

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