Objective To investigate the effect, if any, of renal failure upon pro
state-specific antigen (PSA) levels and the validity of PSA estimation
as a marker of prostatic disease in renal failure. Patients and metho
ds PSA was measured in 65 men (median age 67 years, range 39-84) on re
gular haemodialysis and 37 men (median age 70 years, range 42-77) on c
ontinuous ambulatory peritoneal dialysis (CAPD), Patients with a PSA l
evel >4 ng/ml, underwent prostatic biopsy guided by transrectal ultras
onography. Results There was no evidence of an artefactual elevation o
f PSA attributable solely to renal failure. All eight patients with a
PSA level >4 ng/mL had prostatic disease. Conclusion PSA measurements
in patients with end-stage renal failure treated by dialysis remain a
useful marker of prostatic disease.