title: Differences in prostate cancer detection rates according to the level of glomerular filtration rate in patients with prostate specific antigen levels of 4.0-10.0 ng/ml.
abstract: OBJECTIVE
  To investigate differences in prostate cancer detection rates according to the level of glomerular filtration rates (GFR).
  
  
  METHODS
  Patients with prostate-specific antigen (PSA) levels of 4.0-10.0 ng/ml were analysed. Age, serum creatinine, estimated GFR, body mass index, total PSA (tPSA), free PSA (fPSA), per cent free PSA (%fPSA), comorbidities, biopsy Gleason sum and per cent positive core were retrospectively reviewed. All parameters were compared to show whether patients with GFR <60 ml/min/1.73 m(2) (group A) have higher risk of prostate cancer than patients with GFR ≥ 60 (group B). The primary endpoint was cancer detection rate and the secondary endpoints were differences in mean tPSA, fPSA, %fPSA and pathologic outcomes.
  
  
  RESULTS
  A total of 1092 men (243 cancer patients) were included. Mean age was 65.8 ± 7.7 years. No differences in mean age and tPSA were found between groups A and B. Mean fPSA, %fPSA and cancer detection rate were significantly higher in group A than group B. The incidence of %fPSA <25% was significantly lower in group A than in group B. GFR <60 ml/min/1.73 m(2) , fPSA and %fPSA <25% were significant predictors for the presence of prostate cancer in patients with tPSA between 4 and 10 ng/ml. However, %fPSA <25% was not a significant predictor for group A.
  
  
  CONCLUSIONS
  Because of the increased cancer detection rates in patients with CKD of stage ≥ 3 whose tPSA levels are 4.0-10.0 ng/ml, performing prostate biopsy should be actively considered in patients with CKD.
authors.affiliation: Department of Urology, Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Cho
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.forename: S B
authors.initials: SB
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Son
authors.forename: H
authors.initials: H
authors.lastname: Jeong
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen