Serum Tumor Markers in Hemodialysis Patients

Abstract

Aims The main objective of this work was to evaluate the influence of end-stage renal disease (ESRD) on concentrations of five tumor markers (TMs): carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9 (CA19-9), CA15-3, CA125, and prostate specific antigen (PSA) in a group of chronic hemodialysis patients (CHPs); and to study the influence of hemodialysis (HD) sessions on concentrations of the same TMs. Methods We compared TMs levels in CHP before HD sessions to a control group of 50 healthy volunteers, the dosages were determined before and immediately after the HD session Comparisons were made before and after correction for dialysis-induced hemoconcentrations. Results We enrolled 74 CHPs, all TM concentrations were higher in this group compared to control group, but this increase was significant for CEA (4.25 ± 2.89 vs 2.41 ± 1.81ng/ml; p<0.0001), CA125 (27.84 ± 92.27 vs 13.30 ± 9.85 ng/ml; p = 0.048) and CA19-9 (19.65 ± 25.02 vs 10.23 ± 11.00 U/ml; p = 0.011). Post-dialysis levels were significantly higher than those in pre-dialysis. CEA (3.35 [2,46-5.51] vs 4,06 [2.60-6.78] ng/ml; p<0.0001), CA125 (13.24 [9.66-18.63] vs 16.01 [11.33-22.53] ng/ml; p<0.0001), CA19-9 (12.29 [5.59-21.97] vs 16.29 [7.18-24.7] U/ml; p<0.0001), CA15-3 (13.06 [10.05-17.48] vs 14.58 [11.72-19.35] ng/ml; p<0.0001 and PSA (0.83 [0.5-1.24] vs 1.06 [0.62-1.43] ng/ml; p<0.0001). Conclusions Our work confirms that HD increases concentrations of the five TMs evaluated and suggests that the use of CA15-3 and PSA remains valid in CHPs since their concentrations were not altered by ESRD, unlike CEA, CA125, and CA19-9.

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

“…On the other hand our results are similar from the authors with Maoujoud et al [18] evaluated the influence of ESRD on concentrations of five tumor markers, including PSA, in 76 patients maintained on low-flow HD. They found that PSA levels were higher in the HD group (n = 76), compared with the control group of healthy volunteers (n = 50); no statistically significant difference was observed between the groups (p = 0.271).…”

Nephro-oncology: a link in evolution

“…modifying the material of membrane or changing in pore diameter; cancer markers with a small molecular weight overpass filter, resulting in reduction of their serum concentrations. Some studies demonstrated that PSA level is not alternated in hemodialysis patients, [48][49][50] although other authors observed an increase in total PSA and in PSA index in this population. 51 Perhaps, the different results seen in the studies mentioned above are due to the different ages of the patients enrolled.…”

“…[46][47][48][49][50][51][52] As regards CA125, some authors observed that the increase concentration of this tumor marker after HD treatment might be gender specific (in male patients), 44 others hypothesized a relationship between elevated CA125 levels and HCV infection. 52 Further studies are needed to evaluate the diagnostic and prognostic value of tumor markers in order to avoid misdiagnosis and unnecessary diagnostic investigations in the presence of renal impairment.…”

The Change in tPSA, fPSA and f/tPSA Levels in Men Undergoing Hemodialysis Effect of Hemodialysis on Serum PSA Levels

“…However, it has been reported that diagnosis and treatment should be considered according to the patient's clinic after the PSA test was measured high (3). Majoud et al reported that post-dialysis PSA levels were higher than pre-dialysis significantly (12). There are also studies reporting that there is no significant difference in serum PSA levels analysed before and after hemodialysis (13,14).…”