BackgroundCentral venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system.MethodsData from the National Kidney Disease Clinical Patient Management System (KDCPMS) was used to determine CVC use and patterns across centres. Data on demographic characteristics, primary cause of end-stage kidney disease (ESKD), comorbid conditions, laboratory values and centre affiliation were extracted for adult HD patients (n = 1, 196) who were on dialysis for at least three months up to end of December 2016. Correlates of CVC use were explored using multivariable logistic regression.ResultsOverall prevalence of CVC use was 54% and varied significantly across clinical sites from 43% to 73%, P < 0.001. In multivariate analysis, the likelihood of CVC use was lower with increasing dialysis vintage, OR 0.40 (0.26–0.60) for 4 years vs 1 year vintage, rising serum albumin, OR 0.73 (0.59–0.90) per 5 g/L), and with cystic disease as a cause of ESKD, OR 0.38 (95% CI 0.21–0.6). In contrast, catheter use was greater for women than men, OR 1.77 (1.34–2.34) and for 2 out of 10 regional dialysis centres, OR 1.98 (1.02–3.84) and OR 2.86 (1.67–4.90) respectively compared to referent group).ConclusionsCatheters are the predominant type of vascular access in patients undergoing HD in the Irish health system. Substantial centre variation exists which is not explained by patient-level characteristics.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-0873-x) contains supplementary material, which is available to authorized users.

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The aim: It aims to study the effect of fasting and low fat diet on ghrelin hormone, glucose level, the liver enzymes AST and ALT. Materials and methods: The experimental study was conducted using 24 healthy young male albino rat weighing 95±5 gram and age 2 month, one-way (ANOVA) were employed to determine a significance of differences. Results: A significant increase p&#8804;0.05 in glucose level of non-fasting control group compere with non-fasting low fat diet group, significant increase p&#8804;0.05 in glucose level of control group fasting for 20h compared with low fat diet fasting for 20h group, significant decrease p≤0.05 when compares non-fasting low fat diet compares to 20h fasting low fat diet and significant decrease p&#8804;0.05 when compares non-fasting control compares to 20h fasting control, while the effect of fasting and low fat diet on ghrelin hormone. A significant decrease p&#8804;0.05 in ghrelin hormone level of non-fasting control group compere with non-fasting low fat diet group, significant increase p&#8804;0.05 in ghrelin hormone of control group fasting for 20h compared with low fat diet fasting for 20h group, non-fasting control compares to 20h fasting control show a significant (p&#8804;0.05) increase, Fasting with low fat diet cause a significant decrease p&#8804;0.05 in ALT level, also in AST level there was a significant decrease p&#8804;0.05 after 20h fasting. Conclusions: The fasting and low fat diet have effected on ghrelin hormone, glucose level and fasting with low fat diet cause decrease in ALT level, also in AST level decrease after 20h fasting in male albino rats.