title: Central nervous system infections among individuals with and without end-stage renal disease.
abstract: OBJECTIVE
  Individuals with immunodeficiencies are at increased risk of central nervous system (CNS) infections. Data are limited on the risk of CNS infections in patients with end-stage renal disease (ESRD).
  
  
  METHODS
  We conducted a population-based, nationwide cohort study among ESRD patients from 1990 to 2009. Data on ESRD patients was obtained from the Danish Nephrology Registry database. Each ESRD patient was matched with up to 19 population controls. Using the National Hospital Registry we identified hospital admissions with CNS infection as primary discharge diagnosis.
  
  
  RESULTS
  The study included 13,374 ESRD patients and 245,397 population controls, providing 67,012 person-years and 2,237,237 person-years of observation, respectively. The overall incidence rate (IR) of first-time hospitalisation for CNS infection was 149 per 100,000 person-years (95%-confidence interval [CI], 123-181) among ESRD patients. The IR of CNS infection was comparable among dialysis and transplant patients. Compared to population controls, the incidence rate-ratio of first CNS infection was 5.58 (95%-CI, 4.47-6.91) for ESRD patients in general. The 30-day mortality following hospitalisation for CNS infections was 21% (95%-CI, 14-30) among ESRD patients and 13% (95%-CI, 10-16) among population controls.
  
  
  CONCLUSIONS
  ESRD patients have considerable excess risk and mortality from CNS infections, which is of great clinical and public health concern.
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark. jesper.damsgaard@studmed.au.dk
authors.forename: Jesper D
authors.initials: JD
authors.lastname: Gunst
authors.forename: Søren
authors.initials: S
authors.lastname: Jensen-Fangel
authors.forename: Bente
authors.initials: B
authors.lastname: Jespersen
authors.forename: Lars
authors.initials: L
authors.lastname: Ostergaard
authors.forename: Ole S
authors.initials: OS
authors.lastname: Søgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002494:Central Nervous System Infections / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D055815:Young Adult