Impact of chronic dialysis on serum PSA, free PSA, and free/total PSA ratio: is prostate cancer detection compromised in patients receiving long-term dialysis?

Objectives. The increased incidence of malignancy (ie, prostate cancer) in patients with end-stage renal failure is well known. However, little is known of the impact of hemodialysis and various membrane types on total and free prostate-specific antigen (PSA). We prospectively studied the impact of...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 1999-06, Vol.53 (6), p.1169-1174
Main Authors: Djavan, Bob, Shariat, Shahrokh, Ghawidel, Keywan, G̈uven-Marberger, Kathrin, Remzi, Mesut, Kovarik, Josef, Hoerl, Walter H, Marberger, Michael
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Emergency and intensive care: renal failure. Dialysis management
Humans
Intensive care medicine
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Male
Medical sciences
Middle Aged
Multivariate Analysis
Nephrology. Urinary tract diseases
Prospective Studies
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood
Prostatic Neoplasms - complications
Prostatic Neoplasms - diagnosis
Renal Dialysis
Time Factors
Tumors of the urinary system
Urinary tract. Prostate gland
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Summary:Objectives. The increased incidence of malignancy (ie, prostate cancer) in patients with end-stage renal failure is well known. However, little is known of the impact of hemodialysis and various membrane types on total and free prostate-specific antigen (PSA). We prospectively studied the impact of high- and low-flux dialysis membranes and kidney function on total PSA (tPSA), free PSA (fPSA), and free/total PSA ratio (f/t PSA). Methods. A total of 149 men were included. tPSA, fPSA, and f/t PSA were measured before and immediately after dialysis with high-flux (n = 101) and low-flux (n = 48) membranes in the serum and in the dialysis ultrafiltrate. A multivariate analysis of the impact of kidney function and age on the rate of change of all parameters was performed. Results. Overall, a significant decrease of fPSA (from 0.49 ± 0.3 to 0.35 ± 0.3 ng/mL, P
ISSN:0090-4295
1527-9995
DOI:10.1016/S0090-4295(99)00010-2