It is important to meet the energy requirements of the patient to prevent tissue catabolism. Diets should have a high energy density, with the energy derived from non-protein sources. Relatively high fat is beneficial as it has twice the energy density of carbohydrate, and improves palatability. The energy requirements of dogs and cats with chronic renal failure have not been established, so it is recommended that standard equations for maintenance are used, with adjustments made according to body condition. Protein restriction is appropriate in the uraemic patient, to improve clinical signs Sodium restriction may help to moderate hypertension.
Potassium supplementation helps to avoid deficiency.
Water soluble vitamin supplementation helps to avoid deficiency. Ideally, the degree of protein restriction should be based on the severity of symptoms. Other therapies may be needed, including the use of erythropoietin and calcitriol, depending on the severity of the disease. A similar approach is recommended for dogs with proteinuria , although it may be necessary to adjust the degree of protein restriction to prevent protein deficiency. Serum albumin concentration should be monitored in these patients.