Huge numbers of patients referred to pain service have kidney function impairment to some extent. Pain physicians face puzzling cases and may find themselves struggling and divided between the decisions of providing adequate pain reliever, at the same time avoiding further damage to kidneys, and excessive accumulation of medications and their metabolites, also negative interactions with patient's other medications. In this chapter, we will reason about the prevalence of pain in patients with

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... al impairment, pharmacodynamics and pharmacokinetics of pain medications in this group, optimization of pain control, preferred choice of drugs according to the level of kidney damage, and feasibility of alternative pain management techniques.