Pain management in patients with chronic kidney disease

Chronic kidney disease (CKD), defined by abnormalities in kidney function or damage stable for more than three months, is a relatively common disease in Japan. A high prevalence of pain-associated disease is reported in the CKD population. Thus, there is ample opportunity to manage pain in patients with CKD in ordinary clinical practice. When administering analgesics to patients with CKD, we should be careful about the status of renal function and the renal excretion rates of parent drug and/or its metabolites, to prevent drug accumulation and increased risk of toxicity. Furthermore, certain analgesics can increase the risk of acute kidney injury and they should be avoided in CKD patients. The aim of this article is to review the considerations needed for pain management in CKD patients.