How would you advise a CKD patient who asks about oral NSAIDs for management of chronic pain if they have a contraindication to taking acetaminophen?

This depends on the severity of the CKD/eGFR, age, course of disease, available alternatives to NSAIDs, severity of pain and impact on QoL, frequency with which NSAIDs might be taken. I have advised patients whose QoL is adversely affected by pain to take occasionally if needed but to keep to minimu...

A few options to consider, beyond a basic risk-benefit discussion with the patient and checking how adverse the NSAID has been to the renal function, if the decision is to use one:

1. Are there other treatments for the pain, such as other anti-inflammatory measures, if the pain is inflammatory (such a...