Serum levels of prostate specific antigen in men on hemodialysis

The measurement of prostate specific antigen (PSA) is widely used for the e arly detection of prostate cancel: However the influence of renal failure o n the serum levels of the PSA molecular forms is still a matter of investig ation. We therefore examined the serum concentration of fetal and free PSA in patients undergoing hemodialysis and discuss the influence of renal fail ure on both types. Materials and Methods: Serum concentrations of total PSA , free PSA and the free-to-total PSA ratio were measured in 48 men undergoi ng hemodialysis. Total and free PSA levels were measured employing a chemil uminescent enzyme immunoassay. Results: Serum levels of total PSA, free PSA as well as the free-to-total PSA ratio did not change significantly in ure mic patients after hemodialysis. Median total PSA concentarion was 1.1 ng/m L before and 1.15 ng/mL after hemodialysis (p = 0.24); median free PSA conc entration was 0.29 ng/mL before and 0.32 ng/mL after hemodialysis (p = 0.14 ). Median free-to-total PSA ratio was 0.29 ng/mL before and 0.31 ng/mL afte r hemodialysis (p = 0.66). Conclusion: Serum free PSA as well as total PSA is not eliminated by hemodialysis and the slightly elevated levels of free PSA and the free-to-total PSA ratio in uremic patients after hemodialysis m ay be caused by the concomitant decrease in binding proteins. We therefore conclude that the reference ranges for total PSA, free PSA and the S-/t-PSA ratio are applicable undergoing chronic hemodialysis.