​  Pruritus in hemodialysis patients (HDP) is one of the serious complications associated with the quality of life and psychiatric disorder of patients. There are only a few treatment options to treat pruritus and their effectiveness is controversial. We designed to compare Nalfuranfine HCL, kappa-opioid receptor agonist, with the narrowband ultraviolet B phototherapy in HDP. Twenty HDP were enrolled from Wonju severance Christian hospital. Visual analog scale (VAS) score and Shiratori score were measured before four weeks of treatment, during four weeks of treatment, and after four weeks of treatment. VAS and Shiratori score is reduced in both Nalfurafine HCL and UVB treatment group (Figure 1). After four weeks of treatment, the UVB treatment group maintained a low Shiratori score. However, nalfurafine treatment group increased the Shiratori score. Calcium phosphate product concentration is increased in the UVB treatment group and decreased in the Nalfurafine treatment group. Vitamin D level is increased only in the UVB treatment group (Figure 2). There are no side effects in both treatment groups. Nalfurafine HCL could be an alternative treatment option as an oral medication in hemodialysis patients.