53% of Pets With Chronic Kidney Disease Survived Dialysis
If your dog or cat has kidney disease and their condition suddenly gets worse, you may wonder whether dialysis could help. A new study looked at exactly that question. Researchers examined 136 dogs and cats — 67 dogs and 69 cats — who received dialysis after their kidneys began to fail. The results suggest that dialysis can still benefit pets with pre-existing kidney disease, but survival rates are lower than in pets whose kidneys were previously healthy.
The findings, published in Frontiers in Veterinary Science, offer real numbers to help pet owners and vets have more informed conversations about this serious treatment option.
Why Kidney Disease in Pets Is Such a Complicated Problem
Kidney disease is one of the most common serious illnesses in older dogs and cats. The kidneys filter waste from the blood and control fluid balance. When they stop working well, toxins build up fast — and that can become life-threatening.
There are two broad patterns that vets watch for. The first is acute kidney injury (AKI) — a sudden loss of kidney function in a pet whose kidneys were previously healthy. This can happen after poisoning, a blockage, or a severe infection. The second pattern is acute-on-chronic kidney disease — when a pet who already has long-standing kidney disease (called chronic kidney disease, or CKD) suddenly gets much worse. This second scenario is trickier because the kidneys are already damaged before the crisis hits.
Dialysis — also called renal replacement therapy — is a way to do the kidneys’ job artificially. It filters the blood outside the body when the kidneys cannot do it on their own. It is an advanced, specialist treatment, not something offered at every vet clinic. A key question for vets has been: is dialysis still worth pursuing in a pet that already has CKD?
How the Study Was Designed
This was a retrospective observational cohort study. That means researchers looked back through medical records of pets who had already received dialysis, rather than running a controlled experiment. They identified 136 animals — 67 dogs and 69 cats — who had undergone renal replacement therapy.
The researchers compared two groups:
- Pets with acute kidney injury (no pre-existing kidney disease)
- Pets with acute-on-chronic kidney disease (prior CKD that got suddenly worse)
Because this was an observational study, it can show associations and patterns — but it cannot prove that dialysis caused those outcomes on its own. Other factors, like how sick each animal was when they arrived, could also play a role.
Survival Rates: What the Numbers Show
Pets With Pre-Existing Kidney Disease Survived at a Lower Rate
The study found a clear difference in survival between the two groups.
- In pets with acute-on-chronic kidney disease, survival to discharge was 53%.
- In pets with acute kidney injury (no prior kidney disease), survival was 70%.
In plain terms: just over half of pets with pre-existing CKD who received dialysis survived to go home. That is meaningfully lower than the seven-in-ten survival rate seen in pets whose kidneys had been healthy before the crisis.
Pre-Existing Kidney Disease Does Not Rule Dialysis Out
The finding that more than half of the acute-on-chronic cases survived is itself significant. The study suggests that having chronic kidney disease does not make dialysis automatically pointless. A pet with CKD who suddenly crashes is not necessarily out of options.
At the same time, the lower survival rate is a real and important difference. Longer-term prognosis for pets in the acute-on-chronic group may also be harder to predict, since the underlying kidney disease was still present even in those who survived to discharge.
The researchers also emphasize that case selection matters. Not every pet in kidney failure is an equally good candidate for dialysis — and veterinary specialists weigh many factors when deciding whether to recommend it.
What a 53% Survival Rate Means for Your Pet
A Diagnosis of CKD Does Not Close Every Door
If your dog or cat has been living with chronic kidney disease and you suddenly find yourself in an emergency situation, it can feel like options are limited. This study suggests that is not always the case. Advanced kidney support may still be viable — though outcomes tend to be worse than in pets without pre-existing disease.
This does not mean dialysis is right for every pet. It is an intensive, specialist-level treatment. The decision involves the pet’s overall health, the severity of the crisis, the likely cause, and what quality of life looks like on the other side. These are conversations to have with a veterinary internal medicine specialist or an emergency and critical care vet.
Questions to Ask if Your Pet Needs Emergency Kidney Support
If a vet raises the possibility of dialysis for your pet, here are some useful questions:
- Is my pet a good candidate given their existing kidney disease?
- What is the likely survival rate given their specific condition?
- What does recovery look like, and what kind of long-term kidney function might they have?
- Are there facilities nearby that offer renal replacement therapy for pets?
- What are the alternatives if we decide against dialysis?
These questions will not all have simple answers, but asking them helps you understand the full picture before making a decision.
Signs That Mean Your Pet Needs Urgent Veterinary Attention
If your pet already has kidney disease, watch for these warning signs and get to a vet right away if they appear:
- Sudden loss of appetite or complete refusal to eat
- Vomiting that won’t stop, especially multiple times in a day
- Extreme lethargy — more tired than usual, can’t stand or barely responds
- Not urinating, or urinating much less than normal
- Twitching, trembling, or seizures
- Swollen abdomen or signs of pain when touched near the belly
These can all be signs that kidney function has worsened sharply, and time matters in these situations.
Study Limitations to Keep in Mind
Because this was a retrospective study — meaning researchers looked at past records rather than running a controlled trial — it has some important limits. The researchers acknowledged that the retrospective design makes it harder to rule out other factors that might have influenced outcomes.
For example, how sick each pet was when they first received dialysis, what caused the acute crisis, and how quickly treatment was started could all affect survival. A future study with a larger group and prospectively tracked data would help confirm these findings and give more detailed guidance on which pets are most likely to benefit.
Chronic Kidney Disease Does Not Rule Out Dialysis
A study of 136 dogs and cats found that pets with pre-existing chronic kidney disease can still survive dialysis — but their survival rate (53%) was lower than in pets with no prior kidney disease (70%). The key takeaway is that a CKD diagnosis does not automatically rule out advanced kidney support, though outcomes are harder to predict and careful case selection by veterinary specialists remains essential.
If your pet has kidney disease and you are worried about what options exist in a crisis, the best step is to establish care with a veterinarian who knows your pet’s kidney history. That way, if an emergency does arise, you will have a team already familiar with your pet’s baseline health and better equipped to guide you quickly.
This article summarizes peer-reviewed research for educational purposes. Always consult with your veterinarian for personalized advice about your pet’s health and behavior.
