Cats’ kidneys do far more than produce urine, and chronic kidney disease can be difficult to spot until it has progressed. These nine facts explain what kidneys do, what changes to watch for, how veterinarians assess kidney health, and when urinary trouble is an emergency.
1. Kidneys do more than make urine
Kidneys filter metabolic waste from the blood and produce urine, but they also help regulate the body’s fluid volume, important chemicals, and blood pressure. Their filtering tissue contains many tiny functional units called nephrons. When kidney function declines, the effects can reach beyond urination.
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Cornell Feline Health Center: Chronic Kidney Disease; Cornell Feline Health Center: Bladder and Kidney Stones.
2. Chronic kidney disease is common in older cats
Cornell University College of Veterinary Medicine reports that chronic kidney disease (CKD) affects up to 40% of cats over age 10 and 80% of cats over age 15. These are population estimates from Cornell’s 2025 guidance, not a prediction that any particular older cat has CKD. Cornell identifies age as the only known risk factor discussed on that page.
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3. Early CKD may not be obvious at home
A cat with early CKD may show no clear signs. As the kidneys lose some ability to concentrate urine, increased urination and thirst may become noticeable. Later signs can include reduced appetite, weight loss, lethargy, and an unkempt coat. None of these symptoms alone confirms kidney disease; they can have other causes and merit veterinary assessment.
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Those changes can occur with CKD, but they are not specific to it. A veterinarian can consider them alongside an examination and appropriate testing rather than diagnosing from thirst or litter-box habits alone.
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4. Kidney disease can affect blood pressure and red blood cells
Kidneys contribute to blood-pressure regulation and produce erythropoietin, a hormone involved in red blood cell production. CKD can therefore be associated with high blood pressure (hypertension) and anemia. Cornell reports that approximately 60% of cats with CKD also develop hypertension; the figure is a reported estimate, not an individual cat’s likelihood.
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Veterinarians interpret kidney-related results together with the cat’s hydration and overall clinical condition. Cornell describes assessing measures such as blood urea nitrogen (BUN), creatinine, SDMA, electrolytes, red blood cell counts, and protein, as well as urine concentration and urine protein. Depending on the case, evaluation may also include a urine culture, blood-pressure measurement, or imaging.
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- Blood tests: BUN and creatinine can be affected by dehydration; low muscle mass can affect how creatinine is interpreted. Cornell notes that creatinine usually does not rise until a cat has lost almost 75% of renal function, while SDMA elevations can be detectable after about 40% loss. These are Cornell’s general explanations of test sensitivity, not precise measurements of an individual cat’s kidney function.
- Urinalysis: Urine concentration and protein provide information that a blood test alone cannot supply.
- Blood pressure and other tests: These can help identify complications or clarify the clinical picture when indicated.
Cornell recommends interpreting results in a stable, well-hydrated cat and ideally considering at least two sets of blood and urine samples obtained within two weeks. Your veterinarian decides which tests and timing fit the cat’s circumstances.
6. CKD staging follows diagnosis
Staging is a framework for communicating about CKD and guiding management, not a standalone diagnosis or a substitute for assessing the individual cat. The International Renal Interest Society (IRIS) framework stages CKD and further substages it according to proteinuria and systemic blood pressure. Cornell also emphasizes that a cat should be stable and hydrated for meaningful staging.
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IRIS says its core guidance documents were revised in 2026. Because recommendations may change, veterinarians should consult the current IRIS guidelines and IRIS staging system when applying the framework.
7. CKD care aims to slow progression and preserve quality of life
Cornell describes CKD as progressive and without a definitive cure. Management is individualized: a veterinarian may address nutrition, hydration, monitoring, and complications according to the cat’s needs and response. IRIS likewise notes that treatment emphasis varies with stage and the patient.
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Food and water choices need to fit the cat
If a therapeutic diet is recommended, transition gradually and make sure the cat continues eating; a veterinarian can help address refusal or other feeding concerns. Provide clean, fresh water. Some cats prefer fountains, but a fountain is an optional way to offer water, not a treatment or prevention for kidney disease. Advice about fluids, medicines, supplements, or diet should be tailored by a veterinarian.
8. Kidney stones and a urinary blockage are not the same problem
Kidney stones may cause no noticeable signs until they are large, according to Cornell. A complete urinary blockage that prevents a cat from passing urine is different and is a medical emergency: seek immediate veterinary care if a cat cannot urinate. See Cornell’s guidance on bladder and kidney stones.
9. Some kidney disease is inherited
Polycystic kidney disease occurs most often in Persian cats and occasionally in breeds including Himalayans and British Shorthairs. Cornell states that ultrasound is needed for definitive diagnosis. Genetic testing can identify a gene carrier, but it does not show how severely that cat is affected. Read Cornell’s overview of polycystic kidney disease.
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