Abstract: Objective To explore the relationship between blood trace elements and degrees of chronic kidney disease-related pruritus(CKD-aP) in maintenance hemodialysis(MHD) patients. Methods For this single-center and cross-sectional study, 121 patients receiving regulartreated at our blood purification center in September 2019 were enrolled. Their demographic, laboratory and clinical parameters were recorded and the blood levels of manganese, zinc, copper, selenium and lead were measured before dialysis. The degrees of CKD-aP were evaluated by Dirk R Kuypers scoring. They were divided into four groups of non-pruritus, mild/moderate/severe pruritus. The clinical characteristics of each group were analyzed. Multivariate ordinal Logistic regression was employed for analyzing the associations between the degrees of CKD-aP and blood levels of various elements. Results A total of 121 patients were enrolled, including 45 patients without pruritus was none(n=45), mild(n=59), moderate(n=12) and severe(n=5). The proportion of male was higher than that of female in mild/severe pruritus group and the proportion of female higher than that of malein moderate pruritus group(P<0. 05). The greater degree of pruritus, the higher level of C-reactive protein(P<0. 05). Although the levels of blood trace elements showed no statistical significance among four groups. Univariate analysis revealed that blood manganese was correlated with a higher pruritus degree whereas other trace elements had no correlation with pruritus degree. After adjusting various confounding factors, multivariate ordinal Logistic regression analysis indicated that a lower blood level of manganese was independently associated with a greater degree of CKD-aP in MHD patients(P<0. 05). Conclusion A low blood level of manganese may play an important role in CKD-aP in MHD patients.