PMID- 12584285
OWN - NLM
STAT- MEDLINE
DCOM- 20030716
LR  - 20191210
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 18
IP  - 3
DP  - 2003 Mar
TI  - Percent-free prostate specific antigen is elevated in men on haemodialysis or 
      peritoneal dialysis treatment.
PG  - 598-603
AB  - BACKGROUND: Men with chronic renal failure evaluated for transplantation are 
      often tested for prostate specific antigen (PSA) to detect prostate cancer. PSA 
      occurs in several different molecular forms in serum: free PSA (fPSA) and 
      complexed PSA (cPSA), the sum of which corresponds to total PSA (tPSA). In 
      addition to tPSA, percent fPSA to tPSA (%fPSA) is widely used to enhance 
      discrimination of benign disorders from prostate cancer. The low molecular mass 
      of fPSA suggests elimination by renal glomerular filtration and that renal 
      failure may significantly influence %fPSA. We evaluated whether established 
      reference levels for %fPSA are applicable also to patients treated with 
      haemodialysis or continuous ambulatory peritoneal dialysis (CAPD). METHODS: The 
      study included 20 men on intermittent haemodialysis with low-flux membranes and 
      25 men on CAPD, without known history of prostate cancer. The control group 
      included 3129 men without known prostate cancer. We analysed fPSA and tPSA in 
      serum by dual-label immunofluorometric assays, from which we calculated %fPSA and 
      cPSA. Serum levels of different PSA forms were adjusted for age and presented as 
      geometric means. RESULTS: Percent fPSA was significantly higher in patients on 
      either haemodialysis (39.5%) or CAPD (39.6%) compared with controls (28.1%). 
      Haemodialysis patients, but not CAPD patients, had significantly higher mean 
      levels of fPSA. Levels of tPSA and cPSA for haemodialysis or CAPD patients did 
      not differ significantly compared with controls. CONCLUSIONS: Recommended 
      reference ranges for %fPSA, based on men with normal renal function, do not apply 
      to uraemic men on dialysis. In these men, a high %fPSA should not be considered 
      as a sign of benign disease. This is clinically important in the evaluation of 
      dialysis patients for transplantation, as %fPSA is often used as a tool for 
      detection of prostate cancer.
FAU - Bruun, Laila
AU  - Bruun L
AD  - Department of Nephrology and Transplantation, University Hospital, Malmo, Sweden. 
      laila.bruun@klkemi.mas.lu.se
FAU - Bjork, Thomas
AU  - Bjork T
FAU - Lilja, Hans
AU  - Lilja H
FAU - Becker, Charlotte
AU  - Becker C
FAU - Gustafsson, Ove
AU  - Gustafsson O
FAU - Christensson, Anders
AU  - Christensson A
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Humans
MH  - Kidney Failure, Chronic/*blood/*therapy
MH  - Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - *Peritoneal Dialysis, Continuous Ambulatory
MH  - Preoperative Care
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*blood
MH  - Reference Values
MH  - *Renal Dialysis
EDAT- 2003/02/14 04:00
MHDA- 2003/07/17 05:00
CRDT- 2003/02/14 04:00
PHST- 2003/02/14 04:00 [pubmed]
PHST- 2003/07/17 05:00 [medline]
PHST- 2003/02/14 04:00 [entrez]
AID - 10.1093/ndt/18.3.598 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2003 Mar;18(3):598-603. doi: 10.1093/ndt/18.3.598.