PRURITUS is a common challenging symptom seen in chronic kidney disease (CKD). Approximately 40% of patients with end-stage renal disease have pruritus. Many patients with CKD-associated pruritus (CKD-aP) have reported a lack of sleep, mental health issues, and poor quality of life. Despite the prevalence of CKD-aP, treatment options are limited. There is an urgent need to address this clinical gap and reduce the impact on patients with CKD-aP. This review explored the unmet medical needs in CKD-aP, diagnostic challenges, and potential treatment options.