Abstract

Little is known of the impact of hemodialysis on serum total (tPSA) and free PSA (fPSA) levels. We prospectively studied the impact of hemodialysis with low-flux membranes on serum tPSA, fPSA and free/total PSA (f/tPSA) ratios.

A total of 46 men under chronic hemodialysis treatment were included. tPSA, fPSA, f/t PSA were measured before and after the dialysis with low-flux membranes in the serum and in the dialysis ultrafiltrate. The control group consisted of 216 healthy male individuals.

There were no statistically significant difference between the serum levels of tPSA and fPSA in hemodialysis patients and controls (p>0.05 and p>0.05, respectively). However, f/tPSA ratios of hemodialysis patients were significantly higher than those in controls (45.4±18.1 and 32.12±16, respectively; p<0.0001). Although, there was a statistically significant increase of mean tPSA and fPSA levels before and after dialysis (before 1.15±1.0 ng/mL versus 1.4±1.2 ng/mL; p<0.0001 and before 0.44±0.29 ng/mL versus 0.54±0.36 ng/mL; p<0.0001, respectively), there was no statistically significant difference between mean f/tPSA before and after dialysis (before 45.4±18.1% versus 44.7±16.5%; p=0.746). Neither tPSA nor fPSA could be shown in the ultrafilrate of any hemodialysis patients.

PSA molecules are not eliminated by hemodialysis with low-flux membranes. Serum tPSA, fPSA and f/tPSA are reliable parameters in the evaluation of patients in chronic hemodialysis with low-flux membranes.