Is Systemic Inflammation Associated With Elevated PSA Serum Levels In Patients Submitted Chronic Hemodialysis?

Abstract

Background: Whereas that systemic inflammation (SI) affects 40-60% of patients on hemodialysis (HD) is characterized by serum Creactive protein (CRP) level elevation or proinflammatory interleukin production or both. We evaluated the association between SI and total (tPSA) and free PSA (fPSA) in patients on HD with tPSA <4ng/ml. Methods:Sixty patients with chronic kidney disease (CKD) undergoing HD and 20 controls were included. Inclusion criteria were patients aged 18-60 years; tPSA < 4 ng/mL without clinically detectable prostate cancer; and patients undergoing HD for >6 months. Patients were excluded if they had local infections or SI. Hs-CRP was measured using turbidimetry, and tPSA and fPSA levels using immunochemoluminescence. Overall, 27 patients had inflammation (hs-CRP >5 mg/L) and 33 had no inflammation (hs-CRP was ≤5 mg/L). In the control group, hs-CRP was ≤ 1 mg/L. Results:There was no significant difference in mean levels among groups 3 and 4 for age (p= 0.058), tPSA (p=0.74) and fPSA (p=0.30). The SI did not promote differences between groups 1, 2 and 4 for the levels of tPSA (0.71 ± 0.18 vs 0.67 ± 0.15 vs 0.67 ± 0.11; p=0.69) and fPSA (0.34 ± 0.01 vs 0.34 ± 0.01 vs 0.35 ± 0.01, p= 0.59). As well as maintained no correlation with tPSA and fPSA (p> 0.05). Conclusion:The results of this study suggest that systemic inflammation is no associated with changes fractions of tPSA and fPSA in chronic hemodialytic patients without clinically detectable cancer (PSA<4ng/ml).