Chronic kidney disease (CKD) is common in dogs and cats and can occur at any age, especially in geriatric animals. The various presentations of the disease and their different hemodynamic and metabolic alterations are issues of profound research. Currently clinicians improvements of the comprehensive management of chronic kidney disease focuses on the delay of the progression of clinical signs of the disease and there now are numerous novel methods that also were proposed to slow the progression of the disease, with the possibility of use in non-referral centers. The aim of this critical approach is to provide an overview of the comprehensive treatment of chronic kidney disease, expose new treatments that could improve the intervention of dogs and cats with chronic kidney disease and reevaluate the usefulness of some existing drugs.

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