I am unable to make a specific diagnosis based on the information that you present. Chronic uremic pruritus is a very challenging disease to treat. It sounds like you have tried most recommended treatments. In some cases, I have sought consultation with a dermatologist to see if there are other treatments that are available. It is important to keep your blood phosphorus in the normal range. This should help with the itching. If your parathyroid hormone levels are very high, you may need aggressive treatment of your hyperparathyroidism to bring the levels into the target range. I recommend that you review your dialysis treatments with your dietitian and your nephrologist for recommendations about your dialysis prescription.