I am lead to believe that there is other renal on the market but my fussy eater (Border Collie) enjoys it. Hopefully its keeping him alive, still wetting his bed so still over drinks with the kidney probs. So i could say the food is keeping him well, alive. Now on no other medication, & "No treats" at all, none. over a year, approaching 18 months now. Rare for this illness & age (11) I believe. Worth every penny to me, but same it does cost so much, hence 4/5.
I bought this food on the advice of my vet, because my 14 year old dog had renal disease. After a week, his renal symptoms have disappeared (they had been increasing). Still I plan everything to avoid a resurgence.
In addition, the kibble is small which allows him to suffer less with pain in his teeth.