We are grateful for the opportunity to respond to Hiremath et al.1 Our clinical guide presents a framework on managing pain in patients with kidney disease for practitioners to reference while using their judgment when prescribing medications.2 Our caution regarding NSAID use is intended as guidance rather than an absolute contraindication. We strongly support matching treatments with patient preferences, including judicious use of NSAIDs. The findings from Möller et al3 should be interpreted in the context of a healthy population, 80% of whom had CKD stage 1 or 2.