The progression is definitely there.I would give your vet a call and see what they recommend. Is he willing to eat other foods? If he hasn't had bloodwork recently, it probably wouldn't be a bad idea to check that to see if there is progression of the disease that might be causing his inappetence. The toxins that build up in the blood from kidney disease can cause nausea, and there are medications that sometimes are prescribed to combat that. If he won't eat at all, tooth problems are always a possibility in an old dog, particularly if that's what caused the swelling in his face before. If he's willing to eat some things, you may be able to try a different kidney food, or either home make food, or try to select a commercial food that's fairly kidney friendly. You also might try mixing a little bit of something he likes into it to see if you can peak his interest.
My old dog has had kidney disease for over 2 years and has refused the rx kidney food completely for almost a year now, and only ate it sporadically before that. It's not a very appetizing food, which is a design flaw IMO since most dogs with renal dz are picky old dogs, but probably the nature of the beast since they're looking for minimal protein, phos, etc. She's on a couple supplements (Renal Essentials and Azodyl) to help neutralize the byproducts of her kidney disease since she will only eat meaty "normal dog" foods. She had bloodwork done yesterday, and her kidney values have actually improved over her values a year ago when she was on the kidney diet, so all is not lost if he decides never to eat it again. When I was lamenting to my vet about her refusal to eat the kidney food, he said it wasn't a huge deal, as long as she is eating something.
I gave him rice and egg whites and he ate that in a second (along with the Ipakitine powder). Can you recommend some home made food that I can mix with his Renal food?