The goals of managing patients with CKD are to (Polzin et al, 2005):
- control clinical signs of uremia
- minimize disturbances associated with fluid, electrolyte and acid-base balance
- support adequate nutrition
- modify progression of CKD
Nutritional management plays a role in all of these goals and is indicated to address the etiopathogenic mechanisms that occur in CKD (Table 37-9). In addition, the use of an appropriately formulated commercial veterinary therapeutic renal food is the only treatment that has been shown in randomized, controlled clinical studies to prolong survival time and improve quality of life in dogs and cats with CKD (Polzin et al, 2009; Roudebush et al, 2009; Jacob et al, 2002, 2004; Ross et al, 2006). Therefore, nutritional intervention should be considered a critical component of managing patients with CKD.