Chronic kidney disease (CKD) prevalence increases with population aging and makes drugs prescription more difficult. Only a few studies have reported drug dosing adjustment in CKD patients, even in the important field of pain management. We propose an algorithm based on the current literature that helps in selecting right analgesic according to the degree of renal failure. Drug dosing adjustment of the most usually used analgesics (acetaminophen, nonsteroidal anti-inflammatory drugs and opioids) is discussed.