Koncicki and colleagues1 offer a timely guide to pain management in chronic kidney disease (CKD). However, it relies heavily on the World Health Organization (WHO) pain ladder (originally created to guide the treatment of cancer pain), with the major adaptation to avoid nonsteroidal anti-inflammatory drugs (NSAIDs). The recent Centers for Disease Control and Prevention (CDC) guideline with its emphasis on avoiding opioids for chronic pain would have been a safer resource.