Pruritus may be localized or disseminated and is the most common symptom of ESRD. It occurs in about 53% of these patients, causing great harm to their quality of life. 6,15,16 It is not associated with other primary or systemic skin diseases, psychological disorders or acute renal failure. The pathogenesis is not fully known, but there is a relation with hyperparathyroidism, xerosis, hypervitaminosis A, iron deficiency anemia, and elevated serum levels of magnesium, calcium, phosphate, aluminum and histamine, though the latter may be associated with allergic sensitization to components in dialysis membranes. Pruritus9.17 to 20 contributes to the appearance of perforating injuries by the Koebner phenomenon.