Summary: Pain is common symptom in patients with kidney disease. This problem concerns patients with early, advanced and end-stage kidney disease, as well as renal replacement therapy patients. The causes of pain are varied, but pain is often undertreated in patients with renal failure. The use of appropriate analgesic treatment in patients with renal insufficiency is a major problem. This is due to many factors, and the data from the literature clearly show that pain in patients with kidney disease is not properly treated. The kidneys and liver are the two most important organs that metabolize drugs and remove metabolites from the body. Drugs cleared mainly by the kidneys require dose adjustment depending on the severity of kidney disease, or they cannot be used in people with renal insufficiency due to possible accumulation or toxicity. The inappropriate use of certain analgesics can also lead to impairment of renal function. It should also be take into consideration, that during dialysis some analgesics are removed from the body and pain relief may not be sufficient. This study will present the current knowledge about the pharmacotherapy in patients with chronic pain in various stages of renal failure, with a focus on minimizing the complications caused by the therapy. Treatment of chronic pain nociceptive and neuropathic in this group of patients will be presented, taking into account the mechanism orientated treatment and severity of pain.