Risk Assessment and DiagnosisAssociation Between Glomerular Filtration Rate, Free, Total, and Percent Free Prostate-specific Antigen
Section snippets
Study Population
NHANES is a nationally representative cross-sectional survey of the adult U.S. noninstitutionalized population. A detailed description of sampling and data collection procedures has been described elsewhere.8 People with low income, adults aged 60 years or older, African-Americans, and Mexican-Americans were oversampled. Overall response rates for the 2001-2002, 2003-2004, and 2005-2006 surveys were 84%, 79%, and 80% for the interview component, and 80%, 76%, and 77% for the examination
Results
The distribution of fPSA, tPSA, and %fPSA by GFR category is presented in Table 1. The median fPSA and tPSA increased with successively lower categories of renal function. The percentage of those with %fPSA < 25 decreased with a successive decline in renal function.
Among men with a GFR ≥ 90, the median fPSA was significantly higher among those aged 70-79 years than among those aged < 70 years, and the median tPSA was significantly higher among those aged 50-59 years than among those aged 40-49
Comment
Using nationally representative data, we have confirmed the finding that renal function as measured by GFR is negatively associated with %fPSA. Although tPSA declined somewhat with increasing GFR, this trend was of borderline significance.
One previous study examined the relationship between fPSA, %fPSA, and GFR (measured by the gold standard iohexol clearance method). The study found that median fPSA and %fPSA levels were significantly higher among men with a GFR < 90 and that there was a
Conclusions
Studies have consistently shown that fPSA and %fPSA are elevated in men with end-stage renal disease or on dialysis. This cross-sectional study found that in patients with moderately impaired kidney function, the moderately decreased GFR resulted in a significantly increased %fPSA, thus, significantly expanding the population for which this finding may be important. Additional studies are needed to determine what effect this finding may have on prostate cancer detection in men with GFR between
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Prostate health index and prostate cancer gene 3 score but not percent-free Prostate Specific Antigen have a predictive role in differentiating histological prostatitis from PCa and other nonneoplastic lesions (BPH and HG-PIN) at repeat biopsy
2015, Urologic Oncology: Seminars and Original InvestigationsCitation Excerpt :Atypical small acinar proliferation cases were excluded, as they very often show false-negative results at first biopsy. Patients with marked blood protein alterations, having hemophilia, or with moderately impaired kidney function were excluded from the study because such conditions may alter p2PSA concentration, which is necessary to calculate the PHI [16]. Patients then underwent transrectal ultrasound-guided re-Bx, according to a standardized extended scheme: at least 18 peripheral and transition zone cores were performed by experienced urologists.
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Prostate specific antigen levels and prostate cancer detection rates in patients with end stage renal disease
2012, Journal of UrologyCitation Excerpt :The 95th percentile reference ranges were derived from 2,119 healthy men between ages 40 and 79 years with no history of PCa or prostatectomy and determined by age in decades, as in our study. While renal dysfunction, hemodialysis and renal transplantation do not affect circulating total PSA, they increase free PSA.19–23 There is concern that using PSA to screen for PCa in the general population may potentially lead to the over diagnosis and subsequent overtreatment of clinically insignificant tumors.24
Association between smoking status, and free, total and percent free prostate specific antigen
2012, Journal of UrologyCitation Excerpt :The NHANES is a nationally representative cross-sectional survey of the adult United States noninstitutionalized population. A detailed description of sampling and data collection procedures has been published elsewhere.14 The overall response rates for the 2001 to 2002, 2003 to 2004 and 2005 to 2006 surveys were 84%, 79% and 80% for the interview component, and 80%, 76% and 77% for the examination component, respectively.
The findings in the article represent those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.