Dietary Tips and Fresh Food Options for Cats With Chronic Kidney Disease

By Angela Beal, DVM

Chronic kidney disease (CKD) is a common condition affecting older cats, and while the disease is incurable, treatments can slow progression. One of the most effective treatments in the CKD toolkit is also one of the easiest to implement: dietary management. 

However, finding the right diet for a cat with CKD can be challenging. Options include commercial therapeutic diets, fresh food, or a hybrid model. This post breaks down research-backed dietary strategies for managing feline kidney disease and how to fine-tune your current cat food routine. 

Nutritional management of kidney disease in cats 

Renal disease interferes with a cat’s ability to filter and eliminate waste, balance electrolytes, and maintain hydration. Symptoms include weight loss, nausea and vomiting, dehydration, lethargy, and high blood pressure. Nutritional interventions can help reduce the kidneys’ workload, helping cats feel better and significantly slowing disease progression. 

The International Renal Interest Society (IRIS) says dietary modification is the most effective long-term management tool for cats with CKD, helping them live months or years longer.

Cats with kidney disease need different levels of specific nutrients than healthy cats. Diets for cats with renal issues should include:

- Lower phosphorus – Cats with kidney issues struggle with calcium/phosphorus balance. High phosphorus levels may cause faster CKD progression, and dietary restriction can help preserve kidney function.

- High-quality protein – Protein metabolism leads to waste products in the blood that failing kidneys struggle to filter. A CKD-friendly diet provides enough high-quality protein with all essential amino acids to maintain muscle, but not more than the kidneys can handle, which varies depending on disease stage.

- Increased moisture – Moisture in canned and fresh diets helps prevent dehydration caused by renal disease.

- Higher potassium – Many affected cats develop low blood potassium levels (i.e., hypokalemia), which can exacerbate symptoms and cause other problems, like heart arrhythmias. Supplemental potassium can keep levels in the normal range.

- Omega-3 fatty acids – EPA and DHA from fish oil may have anti-inflammatory effects that protect the kidneys.

- Higher caloric density –  Cats with CKD commonly have a poor appetite, and tasty, energy-dense foods help prevent weight loss and muscle wasting.

 Choosing a diet for cats with kidney issues

The challenge of feeding a cat with kidney insufficiency is finding something that will entice them to eat when they aren’t feeling their best. Thankfully, you’ve got options. Here’s a look at popular choices and how to determine which is right for you and your cat.

Therapeutic diets

These are commercially produced, research-backed, prescription diets provided by your veterinarian. They come in standard kibble and canned forms, though vets often recommend the canned versions because they contain more moisture. Studies show that these diets can help cats with CKD feel better and live longer compared to standard maintenance diets, and they are regulated with strict quality control standards to ensure precise nutrition for your feline friend.

Despite their benefits and proven ability to help cats, therapeutic diets have some downsides. Your cat may not like the food, and it can’t help them if they won’t eat it. Prescription diets are also pricier than other diets. Another frequently encountered problem is that there are limited options in formulation, so it can be hard to find one that addresses all of an older cat’s nutritional needs and health conditions.

Fresh food

Fresh food is an excellent option for cats who won’t eat prescription diets or pet owners seeking a more natural, whole-food approach. Diets made with fresh ingredients are minimally processed and retain their natural moisture, and they are ideal for cats who need a custom diet.

The catch with fresh cat food is that it must be carefully formulated, especially for cats with medical conditions like kidney disease. Nutrition is complicated, and studies find that homemade diets often lack essential nutrients, which can cause deficiencies and worsen kidney issues rather than improving them. For example, they might have the wrong mix of amino acids, too much phosphorus, or a harmful calcium-to-phosphorus ratio. 

Here are some tips for feeding a fresh food diet to cats with renal compromise:

- Don’t use a generic recipe or try to formulate one yourself.

- Work with a veterinary nutritionist to develop a CKD-appropriate recipe that also addresses your cat’s preferences and other health needs, like food sensitivities, joint conditions, or weight concerns.

- Maximize convenience by engaging a licensed pet food manufacturer like WAB to produce custom formulations from your veterinary nutritionist.

- If feeding off-the-shelf diets that are marketed for cats with CKD, ensure that they have been formulated by someone with appropriate qualifications.

- Use high-quality meats packaged under strict safety protocols in your vet approved formulation

- Schedule regular check-ins with your vet to determine if the diet is working for your cat or not

Supplemental feeding

If you prefer to stick with canned or therapeutic foods but want to supplement the diet with kidney-friendly ingredients or stimulate your cat’s appetite, you can try:

- Adding vet-approved fresh foods as meal toppers

- Warming food for a few seconds to release aromas

- Switching foods if your cat develops a taste aversion while feeling unwell

- Asking your vet about phosphorus binders, calcium-based supplements that keep some phosphorus from being absorbed

- Adding omega-3 oils sourced from small fishes

- Asking your vet about other supplements like B vitamins or potassium

- Improving gut health with prebiotics and probiotics, which some studies show improves CKD symptoms

Closing thoughts

Nutrition can significantly impact outcomes for cats with renal disease. Trying a therapeutic diet, home-cooked food, or a fresh diet designed to counteract the effects of CKD can add healthy months or years to your cat’s life. 

About the Author:

Angela Beal is a veterinarian and full-time veterinary writer who loves using her writing to help pet owners provide the best possible care for their furry companions.