Diego has had kidney disease since he was 2 years old. I was devastated when I found out. It was a routine exam that led my wonderful vet to dig deeper and catch it before it killed him. We still don't know how it happened, but nevertheless, I immediately took action. I took him to a naturopath vet who recommended the Honest Kitchen (Keen), and he's been eating it since. He loves it. If I kept feeding him kibble or that prescription kibble for kidney issues that most regular vets would recommend, he would likely not still be with me today. I can't really fault them for that, as they aren't nutrition specialists. That's not really their job. The naturopath vet specializes in nutrition. He's 11 years old now and nobody can believe it. He looks amazing, his weight is perfect, his coat is perfect, he still goes on 2 hour beach walks and chases his ball. You would NEVER even know by looking at him that he has kidney disease, and now a heart issue (arrhythmia)as well. I 100% believe his diet has everything to do with his good health. I also add a scoop of rehydrated veggie mix and organic brown rice to his food, as he needed more calories since he can't have too much protein. Keen has turkey, but is pretty low-protein and perfect for him. He also takes some supplements and is on medication for his kidney and heart, but otherwise is about as happy and healthy as can be. I would be lost without this food and recommend it to everyone. My next dog will be getting this from the onset. I'm done with kibble and questionable ingredients. Honest Kitchen is the best and worth every penny, and because if it, I'll probably get to spend another few amazing years with my sweet boy.