Prostate-specific antigen levels in patients receiving long-term dialysis

OBJECTIVE: To investigate the effect, if any, of renal failure upon prostate-specific antigen (PSA) levels and the validity of PSA estimation as a marker of prostatic disease in renal failure. PATIENTS AND METHODS: PSA was measured in 65 men (median age 67 years, range 39-84) on regular haemodialysis and 37 men (median age 70 years, range 42-77) on continuous ambulatory peritoneal dialysis (CAPD). Patients with a PSA level > 4 ng/mL underwent prostatic biopsy guided by transrectal ultrasonography. RESULTS: There was no evidence of an artefactual elevation of 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.