What is true regarding pain management for a patient with chronic kidney disease undergoing treatment for low back pain?

For a patient with chronic kidney disease experiencing low back pain, recommending acetaminophen at a dosage of 650 mg three times daily is an appropriate choice for managing pain. Acetaminophen is considered safer than non-steroidal anti-inflammatory drugs (NSAIDs) for patients with kidney concerns.

NSAIDs can pose a risk to kidney function, as they may lead to renal impairment by inhibiting the formation of prostaglandins, which are important for kidney blood flow and protecting the kidneys from damage. Acetaminophen, on the other hand, is primarily metabolized in the liver and does not significantly affect kidney function, making it a safer option for pain management in this patient population.

Additionally, while narcotics may be an option for some patients, they come with a risk of side effects, dependence, and do not address the underlying inflammatory processes that may be contributing to pain. Thus, acetaminophen offers a balance of efficacy and safety for patients with chronic kidney disease.

Increasing physical therapy could be beneficial, but without adequate pain management, the patient may find it difficult to engage fully in therapy. Switching NSAIDs would not be advisable given the risks associated with this class of medications in the context of kidney disease.