Most people with kidney failure experience pain, most often in their bones and muscles. But the pain is usually due to a complication of kidney failure. It may also be due to the type of treatment.

Kidney failure occurs when your kidneys no longer function well enough to meet your body’s needs. It is also known as end-stage kidney disease (ESKD) or end-stage renal disease (ESRD).

About 60% to 70% of people with advanced chronic kidney disease (CKD) experience pain. And just about all people in the hospital with CKD experience pain as a symptom.

This article explores common causes of pain associated with kidney failure.

Acute vs. chronic renal failure

There are two types of renal failure: acute and chronic.

Acute renal failure occurs when the kidneys fail or stop working suddenly. It’s common among people receiving treatment in the hospital for other serious health conditions, such as a heart attack or pneumonia. The damage from acute kidney failure may be reversible, and symptoms such as pain may go away following treatment.

In contrast, chronic renal failure occurs gradually. It’s common among people with CKD, and the damage it causes is not reversible. This type of renal failure is more likely to cause chronic or ongoing pain.

Pain is a common symptom of kidney failure. Some of the causes of pain linked to kidney failure include:

Mineral and bone disorder

Mineral and bone disorder is a common complication of CKD. It is especially common among people who have kidney failure and receive dialysis.

Mineral and bone disorder doesn’t always cause symptoms. But as it progresses, it can cause aching in your bones and joints.

Calcific uremic arteriolopathy

Also known as calciphylaxis, calcific uremic arteriolopathy (CUA) is a rare but serious condition that occurs among people with ESRD. It causes painful lesions to form on the surface of your skin.

CUA is more common among people assigned female at birth who also have other health conditions, such as diabetes and obesity.

Peripheral neuropathy

CKD and ESRD can damage the nerves that travel from your brain and spinal cord to other areas of your body. This condition is known as peripheral neuropathy.

Peripheral neuropathy may trigger changes in sensation, including pins and needles, numbness, and pain in the extremities.

Pericardial diseases

The pericardium is a thin sac filled with fluid that protects your heart, including the roots of the major blood vessels that stem from your heart.

Heart conditions linked to ESRD include:

Each condition causes chest pain that feels worse when you inhale.

Autosomal dominant polycystic kidney disease

Some types of primary kidney disease are associated with increased pain symptoms. In particular, autosomal dominant polycystic kidney disease (ADPKD) is a rare genetic condition that causes kidney cysts.

Pain is a common symptom. It may be due to:

  • infected, bleeding, or ruptured kidney cysts
  • cyst growth
  • urinary tract infections
  • kidney stones

Dialysis

Although dialysis is an important treatment, it can also be a source of pain in kidney failure. Some people who undergo dialysis report muscle cramps, bloated abdomen, and pain at the insertion site of the needle.

Underlying diseases

People with kidney failure are more likely to have coexisting health conditions that may cause pain. Some coexisting health conditions that studies have linked to pain in kidney failure include:

  • diabetic neuropathy
  • ischemic peripheral artery disease
  • osteopenia
  • osteoporosis

There are many options for managing pain associated with renal failure. Usually, the treatment depends on the cause, type, frequency, and intensity.

Talk with your healthcare team if you have pain associated with renal failure. Possible treatments include medication and behavioral and physical therapies.

Medications for pain linked to renal failure include:

Many of the above medications will require a doctor to adjust the dose, as renal failure can alter the concentration and effect of the drugs. Some opioids, like codeine and morphine, are not safe for people with CKD.

Although research into their effectiveness is limited, other possible treatments for pain linked to renal failure include behavioral and physical interventions, such as:

Resources for support

Chronic and untreated pain linked to kidney failure can significantly affect your quality of life. It’s also linked to symptoms such as depression and anxiety.

Pain is a common symptom among people with ESRD. Although kidney failure doesn’t necessarily cause pain, it is associated with several other complications that do.

Pain treatments include medication and behavioral or physical therapy. Your treatment will likely depend on the cause of your pain. A healthcare professional can suggest the best treatment options for you.

You can promote good kidney health with a nutritious diet, getting enough sleep, exercising, and seeking treatment for underlying conditions such as diabetes or high blood pressure.