Does Evening Primrose Oil Improve Pruritis (Itching) in a Dialysis Population?

Patients with end stage renal failure, undergoing dialysis (in hospital or at home), will be invited to participate. Consenting participants will complete a questionnaire about pruritis (itching). Participants will complete the Polyunsaturated Fatty Acid Food Frequency Questionnaire with an Investigator in a face to face interview. Participants will also complete a 3day dietary recall and Patient Generated Subjective Global Assessment (PGSGA) during the interview. Blood samples will also be taken at baseline and post intervention to measure C reactive protein and red blood cell fatty acid status. Also a doubleblinded, randomised placebo controlled trial will be conducted where each participant will be assigned to receive one of three capsule types: * evening primrose oil (omega 6 fatty acids) *fish oil (omega 3 fatty acids) *placebo (vegetable oil) Patients will be randomised to receive 1 of 3 interventions: 1. Active- Evening Primrose Oil, 1gram three times a day, each capsule contains 100mg of gamma-Linolenic acid 2. Active - Omega -3 Fish oil,1 gram three times a day - each capsule contains 53mg EPA and 250mg DHA, with total omega-3 = 348mg The patients will be asked to take three capsules each day for 4 months. Adherence will be monitored by capsule count at the end of the study as well as monitoring of the red cell fatty acid levels. Efficacy of the active groups will be assessed by response to itching, inflammatory markers .