Chronic Kidney Disease (CKD) is a prevalent and progressive condition affecting a significant number of aging dogs. The International Renal Interest Society (IRIS) classifies CKD into four stages, with Stage 3 indicating advanced disease characterized by persistent azotemia and often proteinuria. Managing CKD in dogs typically involves a multi-faceted approach focused on slowing disease progression, alleviating uremic symptoms, and maintaining a good quality of life. This often includes specialized renal diets, management of complications like hypertension and proteinuria, and, when necessary, the use of targeted supplements.
Renal diets play a crucial role in CKD management by controlling protein and phosphate intake, supporting adequate nutrition, and minimizing electrolyte imbalances. However, for some dogs, diet alone may not be sufficient to address critical issues such as hyperphosphatemia and metabolic acidosis. In such cases, veterinarians may recommend dietary supplements. These supplements can include phosphate binders, which work by chelating dietary phosphorus in the gut, or alkalizing agents, like sodium bicarbonate, to combat metabolic acidosis, a common complication that can exacerbate CKD progression and affect nutritional status.
Recent research has explored the efficacy of various supplements in managing CKD in companion animals. A study on cats demonstrated that a supplement containing calcium carbonate, calcium-lactate gluconate, chitosan, and sodium bicarbonate could significantly reduce serum phosphorus and increase serum bicarbonate levels, leading to improved clinical conditions without adverse effects. Building on these findings, the present study investigates the effectiveness of a similar dietary supplement in dogs diagnosed with IRIS Stage 3 CKD.
Study Design and Methodology
This prospective, randomized, controlled study evaluated the efficacy of a new dietary supplement, “Renal P,” formulated with calcium carbonate, calcium-lactate gluconate, chitosan, and sodium bicarbonate. Twenty dogs diagnosed with IRIS Stage 3 CKD were enrolled. Ten dogs received the supplement daily for 180 days (T group), while the remaining ten served as a control group (C group). All dogs were fed a consistent commercial renal diet (Royal Canin Renal Canine) throughout the study.
Key parameters monitored included hematological values, serum biochemical profiles, venous blood gas analysis (to assess bicarbonate and ionized calcium levels), and urinalysis (specifically the urine protein-to-creatinine ratio, UPC). Blood pressure was also recorded. Data were collected at baseline (T0) and at 30-day intervals up to 180 days (T180). Dogs with pre-existing conditions like acute kidney injury, urinary tract obstructions, or severe heart disease were excluded to ensure a homogenous study population. Ethical guidelines for animal care and use were strictly followed, and informed consent was obtained from all owners.
Key Findings: Supplement Efficacy
The study revealed several significant benefits of the dietary supplement in dogs with IRIS Stage 3 CKD.
Phosphorus and Acid-Base Balance
A primary finding was the significant reduction in serum phosphorus levels in the treated group (T group) compared to the control group (C group). While all dogs in the control group maintained elevated phosphorus levels above the normal range, seven dogs in the T group saw their phosphorus levels normalize within 30 days of supplementation, with the remaining three normalizing by day 90. This indicates the supplement’s effectiveness in managing hyperphosphatemia, a critical factor in CKD progression. [cite:original_study]
Furthermore, the supplement demonstrated a positive impact on acid-base balance. At the study’s outset, most dogs in both groups exhibited bicarbonate levels below the recommended range, indicative of metabolic acidosis. While the supplement did not fully normalize bicarbonate levels in all cases by the study’s end, a significant increase was observed in the T group compared to the C group, suggesting an improvement in buffering capacity. [cite:original_study]
Ionized Calcium and Proteinuria
The study also noted a significant increase in serum ionized calcium levels in the T group from day 120 onwards compared to the C group. Importantly, these increases remained within the normal physiological range, and no instances of hypercalcemia were observed, addressing a potential concern with calcium-based phosphate binders. [cite:original_study]
Regarding proteinuria, while initial UPC values were similar between groups, the T group showed a significant decrease in UPC at days 150 and 180 compared to the C group. This suggests a potential benefit of the supplement in mitigating proteinuria, another hallmark of advanced CKD. [cite:original_study]
Safety and Palatability
A crucial aspect of any therapeutic intervention is its safety and ease of administration. The study reported no adverse effects such as vomiting, diarrhea, or anorexia in the dogs receiving the supplement. Owners unanimously reported that the supplement was easy to administer and palatable, with all dogs consuming the entire daily dosage. This high compliance is a significant advantage for long-term management. [cite:original_study]
Discussion and Conclusion
The results of this study suggest that the tested dietary supplement, containing calcium carbonate, calcium-lactate gluconate, chitosan, and sodium bicarbonate, can be a valuable supportive treatment for dogs with IRIS Stage 3 Chronic Kidney Disease. Its ability to effectively reduce serum phosphorus, improve metabolic acidosis, and potentially decrease proteinuria, coupled with a favorable safety profile and owner compliance, highlights its therapeutic potential.
While the supplement showed promising results in improving key clinical parameters, it’s important to note that it did not fully normalize all values, such as bicarbonate levels, in severely affected dogs. This suggests that in advanced stages or cases with significant metabolic derangements, higher dosages or combination therapies might be necessary. However, the supplement’s dual action—combining phosphate binding and alkalizing properties—simplifies treatment for owners.
The findings align with previous research indicating the benefits of such multi-component supplements in managing feline CKD. The observed reduction in serum phosphorus and the improvement in acid-base balance are critical for slowing disease progression and improving the overall health status of CKD dogs. Further research involving a larger cohort of dogs across different IRIS stages could provide even more comprehensive insights into the supplement’s broad applicability in canine nephrology.
In conclusion, this study provides strong evidence supporting the use of this specific dietary supplement as an effective and safe adjunct therapy for managing Chronic Kidney Disease in dogs, contributing to better patient outcomes and improved quality of life.
