Sample Diets for Dogs with Kidney Disease

Why Feed a Dog with Renal Failure Fresh Food?

Feeding a dog with kidney disease a homemade diet or a partially homemade diet is often beneficial for many reasons. Dogs with chronic kidney disease (CKD) often experience loss of appetite, and fresh food is generally more enticing than commercial food. Many believe that fresh food is more healthful than commercial food as many commercial diets are not made with human grade ingredients. Preparing your dog’s meals when they have a health condition can be extremely rewarding. As with all homemade diets, proper planning is needed to assure all of your dog’s nutritional needs are being met.

Basics to Follow:

Limit phosphorus: Dogs with CKD need a diet that is lower in phosphorus than dogs with healthy kidneys. This is one of the most important things to account for in a homemade kidney friendly diet. When designing a diet you should focus on choosing foods that are lower in phosphorus. Foods lowest in phosphorus include high fat meats, white rice, pearled barley, egg whites, and potatoes. Foods that are extremely high in phosphorus include egg yolks, lean meats, liver, dairy, and raw meaty bones (bones are loaded with phosphorus). These foods can still be fed, especially when the kidney disease is in its early stages, but they should be kept to limited quantities. On, is states to feed between 10- 18 mg of phosphorus per lb. of the dog’s bodyweight daily. (Going by these recommendations, a 36 lb. dog with moderate stage kidney disease may be limited to 540 mg of phosphorus per day, putting him at 15mg of phosphorus per pound of bodyweight.) The higher end value is good for dogs with earlier stages of the disease, with the lower amount being suitable for dog with more advanced kidney disease.

Protein: Protein is an extremely important to any dog’s health, yet for the longest time the consensus was that dogs with reduced kidney function should be fed low protein diets. Now, there is a divide amongst veterinarians and owners: some still believe protein is bad for dogs with kidney disease, but others hold firm that protein is still extremely important and should not be drastically reduced. The foods highest in protein tend to also be high in phosphorus, so when phosphorus is reduced protein levels are also cut down to a certain extent. I like the guidelines found on Mary Straus’ website She recommends that unless the dog is uremic, he should still get 1 gram of protein per pound of body weight. So, a dog weighing 20 lbs. would need 20 grams of protein a day. More protein won’t hurt in most cases as long as the phosphorus is kept low.

Fat: Higher fat diets are often recommended for dogs with CKD. High fat foods are usually low in phosphorus, and they provide calories that are extremely beneficial for the dog that is not eating well. It was difficult for me to find information on exactly how much fat to feed. For Lady, who is 50 lbs. I would feed roughly 40 grams of fat to daily. Lady doesn’t tend to have a sensitive stomach. Some dogs are less tolerant to high amounts of fat in their diet. For these dogs, more carbohydrates will need to be fed to assure they are getting enough calories.

Carbohydrates: Low phosphorus carbohydrates are usually a necessary component to a kidney diet. There are many options to choose from, including pasta, white rice (short grain varieties tend to be quite low in phosphorus), pearled barley, sweet potatoes, butternut squash, white bread, etc. Whole grains usually have more phosphorus than refined varieties, so this is a case where whole grains aren’t better.

Calcium: Calcium is very important to any dog’s diet, but it is extremely important for a dog with kidney disease to get enough calcium. Calcium will help bind with excess phosphorus. Mary Straus recommends 1000 mg of calcium per pound of food. Feed regular amounts of calcium if other phosphorus binders are being used.

Fish oil: Omega 3 fatty acids play an important role in reducing inflammation in the body, and studies have shown that omega 3 helps protect kidney function. In her book Raw and Natural Nutrition for Dogs, Lew Olson recommends giving 1000 mg of fish oil per 10 lbs. of bodyweight. This amount may need to be adjusted if your dog is on any medications that may thin their blood, so consult with your veterinarian on the best amounts for your dog.

Other Supplements: If you begin feeding a homemade diet long term, it is imperative to assure all of the nutrients your dog needs are in his diet. There are many companies that produce vitamin and mineral supplements. For a dog with kidney disease, it is important to choose supplements that don’t add phosphorus to the diet. Balance It® has a supplement specifically for dogs with kidney disease that are being fed homemade diets. This may be a good option for your dog. Your vet may also be able to recommend a proper supplement. If you don’t want to worry about balancing your dog’s diet exactly, feed one of the prescription kidney diets in conjunction with homemade food. Feeding at least 75% commercial food should assure your dog is getting everything he needs.

Note: Calcium must still be added to the fresh food to balance out its phosphorus, even if kibble is also being fed.

Much of the information that I have learned about kidney diets comes from I encourage anyone with a dog with kidney disease to read the plethora of information available on that website.

Sample Diets:

These are some of the recipes that I used for nearly 3 years with Lady. This past August, she began refusing most food, and I had to adjust how I feed her, but I truly believe that giving her mostly fresh food for as long as she was willing to eat it has helped keep her with me all this time. Remember to always discuss your dog’s diet with your veterinarian. None of these recipes are complete and balanced by themselves, so supplementation is necessary.

All of the below diets are for a 50 lb. dog that needs approximately 1000 kcal per day. I used for analysis of each recipe

Beef and Barley Recipe:

  • 5 oz. 80/20 ground beef (raw) Note: can substitute 80/20 ground lamb occasionally for variety
  • 3 oz. boneless skinless chicken thigh (raw)
  • 1 oz. beef liver (raw)
  • 1 whole egg
  • 2 oz. veggies (can use zucchini, broccoli, carrots, cauliflower, etc.)
  • 2 oz. pearled barley (uncooked weight)
  • 2 oz. sushi rice (uncooked weight)

Add: 1500 mg calcium

Cook grains according to package directions. Cook meats until done, do not drain the fat. Hard boil or scramble the egg. Steam and mash vegetables. Mix all ingredients together and serve when cool.

Nutritional analysis:

  • Protein: 63 grams
  • Fat: 38 grams
  • Phosphorus: 781 mg
  • 995 kcal

Without proper supplementation, this diet will be low in magnesium, zinc, selenium, iodine, vitamin D, vitamin E, thiamin, and Choline.


Beef and Sweet Potato Recipe:

  • 2 cups sweet potatoes (cooked weight) Note: can substitute 22 oz. cooked butternut squash
  • 3 egg whites
  • 1 oz. beef liver (raw)
  • 2 oz. zucchini
  • 8 oz. 80/20 ground beef (raw)

Add: 1500 mg calcium

Cook meat and retain the fat. Cook sweet potatoes by either baking, steaming, or boiling until very tender. Scramble egg whites. Steam zucchini. Mash ingredients together and serve when cool.

Nutritional analysis:

  • Protein: 64 grams
  • Fat: 47 grams
  • Phosphorus: 714 mg
  • 1000 kcal

Without proper supplementation, this diet will be low in zinc, selenium, iodine, vitamin D, vitamin E, thiamin, and Choline.

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