FrançaisChronic or acute kidney disease
| Chronic kidney disease (CKD) | Acute kidney injury (AKI) | |
|---|---|---|
| How it develops | Slowly, over months or years. | Over hours or days [1]. |
| Typical causes | Ageing, inherited and glomerular diseases. | Toxins (antifreeze, grapes, some medicines), infections such as leptospirosis, poor blood flow or a urinary blockage. |
| Can it recover? | No, but it can often be slowed. | Mild injury can recover within days; severe injury may need dialysis [1]. |
In UK first-opinion practices, CKD was diagnosed in about 0.2–0.4% of dogs; Cocker Spaniels and Cavalier King Charles Spaniels were at higher risk [2].
Symptoms of kidney disease in dogs
- Drinking and urinating more, sometimes accidents in the house.
- Weight loss, reduced appetite, lethargy.
- Bad breath, vomiting or diarrhoea.
These were the signs most associated with CKD in a study of over 100,000 dogs [2].
What the blood and urine tests show
- Creatinine and SDMA rise as filtration falls; SDMA often rises earlier. See creatinine in dogs and SDMA.
- BUN rises too, but also with meals and dehydration. See BUN in dogs.
- Urine specific gravity stays low because the kidneys cannot concentrate. See urinalysis.
- Urine protein (UPC): a UPC of 1.0 or more at diagnosis was linked to about three times the risk of uraemic crisis and death [3]. See protein in urine.
- Phosphorus, potassium and red cells are followed as the disease advances; IRIS considers treating anaemia when the haematocrit falls below 30% [4].
The IRIS stages in dogs
| Stage | Creatinine (mg/dL) | Creatinine (µmol/L) | SDMA (µg/dL) |
|---|---|---|---|
| 1 | below 1.4 | below 125 | below 18 |
| 2 | 1.4–2.8 | 125–250 | 18–35 |
| 3 | 2.9–5.0 | 251–440 | 36–54 |
| 4 | above 5.0 | above 440 | above 54 |
Substages: a UPC above 0.5 is proteinuric in dogs, and blood pressure is classed from normotensive (below 140 mmHg) to severely hypertensive (180 mmHg or more) [5, 6].
Acute kidney injury
IRIS grades acute kidney injury from I to V. Even a rise in creatinine of 0.3 mg/dL or more within 48 hours counts as injury, while the value is still within the normal range [1]. Dogs that produce little or no urine, or have a high potassium, are the most urgent cases [1]. Addison’s disease can mimic acute kidney injury: see Addison’s disease in dogs.
What to expect
In the UK study, the median survival after a CKD diagnosis was 226 days, and the IRIS stage and BUN at diagnosis were linked to the outlook [2]. Dogs diagnosed early, without heavy proteinuria, often do much better; treatment of proteinuria, blood pressure and phosphorus aims to slow the disease [4].
Related articles
En français : l’insuffisance rénale du chien.
An infectious cause of acute kidney injury: leptospirosis in dogs.
Questions to ask your veterinarian
- Is this chronic kidney disease or an acute injury?
- Which IRIS stage and substages does my dog have?
- What do the urine specific gravity and UPC show?
- What is my dog’s blood pressure?
- How often should we recheck the blood and urine tests?
Get your dog’s kidney values explained, stage included.
AI DiagAnimals reads creatinine, SDMA, BUN, the urine and the electrolytes together with your laboratory’s intervals, and prepares the questions for your vet. The service opens soon: leave your email to be told first.
Frequently asked questions
What are the symptoms of sudden kidney failure in dogs?
Vomiting, refusing food, weakness and producing little or no urine. It is an emergency, especially after possible exposure to a toxin [1].
Are dogs in pain with kidney failure?
Advanced kidney disease makes dogs nauseous and unwell, and acute injury can be painful. Treatment aims to keep them comfortable.
How long can a dog live with kidney disease?
It varies widely with the stage at diagnosis and the amount of urine protein. In one UK study, the median survival after diagnosis was 226 days [2, 3].
How can I lower my dog’s creatinine naturally?
There is no safe home remedy. Treatment depends on the cause and stage and should be guided by your vet; kidney diets are part of it [4].
What are the stages of kidney disease in dogs?
Four IRIS stages based on fasting creatinine and SDMA, from stage 1 (creatinine below 1.4 mg/dL) to stage 4 (above 5.0 mg/dL), substaged by urine protein and blood pressure [5].
Sources
- International Renal Interest Society (IRIS). Grading of acute kidney injury, 2026. iris-kidney.com/s/IRIS-AKI-Grading_2026.pdf
- O’Neill DG et al. Chronic kidney disease in dogs in UK veterinary practices: prevalence, risk factors, and survival. J Vet Intern Med. 2013;27(4):814-821. doi.org/10.1111/jvim.12090
- Jacob F et al. Evaluation of the association between initial proteinuria and morbidity rate or death in dogs with naturally occurring chronic renal failure. J Am Vet Med Assoc. 2005;226(3):393-400. doi.org/10.2460/javma.2005.226.393
- International Renal Interest Society (IRIS). Treatment recommendations for CKD in dogs, 2026. iris-kidney.com/s/IRIS-DOG-Treatment_Recommendations_may-2026.pdf
- International Renal Interest Society (IRIS). IRIS Staging of CKD, modified 2026. iris-kidney.com/s/IRIS_staging_guidelines-2026.pdf
- Acierno MJ et al. ACVIM consensus statement: guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med. 2018;32(6):1803-1822. doi.org/10.1111/jvim.15331
Laboratory methods and reference intervals vary. This article explains; it does not diagnose. For a decision about your pet, use the original report and talk to your veterinarian. Our editorial policy.