Having a dog with kidney disease will require significant adjustments in both your pet's lifestyle and the diet you feed him. That being said, there are several ways you can help control your dog's system whether he's uremic or not and ensure he has the highest quality of life possible without sacrificing the tasty treats he's come to enjoy.
One of the first things you'll want to reduce in your dog's diet are carbohydrates. While some carbs are necessary, you need to be smart about the ones you incorporate into your pet's diet. For instance, you can feed pureed or cooked vegetables as well as fruits with the exception of grapes and raisins. Avoid most grains, if possible, though some can be beneficial like Malt-O-Meal or Farina. While it's important to maintain an acceptable level of calories for your dog, you don't want them to be empty calories, which is what many carbs offer.
If your dog is not uremic, a diet that has a good amount of protein in it is good for her. Just make sure the protein is from good sources like egg whites, raw meat, lightly cooked meat and green tripe. Note, however, that dogs that are uremic require a diet that is lower in protein.
A diet low in sodium is recommended for dogs with kidney disease. Since high blood pressure is often present in dogs with kidney trouble, this is doubly good for their health. Sodium should not be eliminated, however, and still plays a vital role in your dog's diet. The key is finding a balance that does not increase blood pressure but maintains kidney function.
Too much phosphorus has shown to be harmful to dogs with kidney disease. A good rule of thumb is to keep your dog's phosphorus intake between 7 to 18 mg/lb. This is low enough so as to not further damage the kidneys but high enough to ensure your dog gets enough of this nutrient. Foods that are high in phosphorus include organ meat, fish and dairy products.