Abstract : A growing number of publications in the literature show that chronic pain is also characteristic of patients with terminal renal failure (TRF). The disease tends to be moderate or severe and affects virtually all aspects of health and quality of life. Unfortunately, there is a lack of clinical and research focus in nephrology, and TAPN pain is poorly understood. The article reflects the main aspects of the problem of pain medication therapy for patients with terminal renal insufficiency receiving chronic hemodialysis. The main pathophysiological mechanisms of medication influence on kidney structures are described.