An-Najah Staff

Objective: To evaluate the effect of hemodialysis on serum total, free and percent-free prostate-specific antigen (PSA) and the role of the kidney in PSA clearance.
Material and Methods: This study included 34 men with chronic renal failure (mean age 58.15, range 45-80 years) who received hemodialysis with low flux membranes. VVe measured pre- and post hemodialysis total PSA (tPSA). free PSA (fPSA) and Hematocrit (Htc) at one dialysis session. Additionally percent fPSA to tPSA was calculated before and after dialysis. Hematocrit was measured before and after dialysis to find the degree of hemoconcentration and to see whether there was a correlation between the increment in PSA level and Hematocrit.
Results: The mean ± standard deviation for all post-dialysis tPSA levels, 1.39 ± 0.25 ng/ml, was greater than that of the pre-dialysis level, 1.19 ± 0.21 ng/ml (mean increment= %16.81,'p = O.0001)While there was no significant increment in fPSA after dialysis (mean increment == %7.5, P == 0,73), there was a significant increment inpercent fPSA (mean increment = %24.49, P == 0.0009). The mean value of Hematocrit after dialysis, 36.9 ± 0.81, was greater than that before dialysis 32.15 ± 0.69 (mean increment == %14.77:P = 0.0001)
Conclusions: The increment in tPSA (% 16.81) was near to the increment of Htc (% 15). So the hemoconcentration seems to be the most possible mean by which the increment in tPSA can be explained. Thus we do not expect a renal role in the clearance of PSA, also we believe that there is no need to adjust the values of PSA used in normal patients for patients with chronic renal failure who are not on dialysis yet. However the increment in Fpsa (%7.5) and percent of fPSA (%24.49) was not like that of hemococentration (% 14,77), so we believe that the recommended reference of %fPSA for normal patients seems not to be applicable for patients with chronic renal failure on dialysis