Clinical Pharmacology Considerations in Pain Management in Patients with Advanced Kidney Failure

Pain is common and poorlymanaged in patients with advancedCKD, likely due to both under and over prescription ofappropriate analgesics. Poorlymanagedpaincontributes topatients'poorquality of lifeandexcessive healthcare use. There is tremendous variability within and between countries in prescribing patterns of analgesics, suggesting that factors other than patient characteristics account for these differences. This article discusses the pharmacologic management of acute and chronic pain in patients with advanced CKD, and the role analgesics, including opioids, play in the overall approach to pain management.