Pain in renal disease.

Pain is the presenting symptom in 20 to 30% of patients with autosomal dominant polycystic kidney disease (ADPKD) and occurs in 50 to 60% of patients at some stage of the disease process, but its frequency increases with age and size of the cysts. Back pain is caused by kidney enlargement as well as rupture, hemorrhage, or infection of cysts. Other causes of pain include nephrolithiasis and urinary tract infections (UTIs). Analgesic options for patients with ADPKD include transcutaneous electrical nerve stimulation (TENS), spinal cord stimulation, low-dose opioids, and local anesthetics.