THE CAUSE OF THE RELATIONSHIP BETWEEN PROSTATE SPECIFIC ANTIGEN AND RENAL FUNCTION ASSOCIATED PARAMETERS: AGE

Yıl 2023, , 190 - 194, 05.04.2023

Eren Vurgun

https://doi.org/10.18229/kocatepetip.1076742

Öz

OBJECTIVE: It was aimed to investigate the relationships between creatinine, estimated glomerular filtration rate (eGFR), urea, uric acid and prostate specific antigen (PSA) levels, that are used in screening, diagnosis and follow-up of prostate and kidney diseases that are common in older man.
MATERIAL AND METHODS: Simultaneously requested serum PSA, creatinine, urea and uric acid results of 7203 males above 40 years old between September 2017 and March 2020 were retrospectively analyzed. The correlations between parameters were evaluated with the effect of age. In addition, the bidirectional relationship between PSA elevation and eGFR decrease was also examined.
RESULTS: There were no effect of creatinine, urea and uric acid levels on PSA levels (p=0.63, p=0.28 and p=0.39, respectively) and similarly, there were no effect of PSA levels on creatinine, urea and uric acid levels (p=0.22, p=0.25 and p=0.92, respectively) when adjusted for age. In the regression analysis with age; while the risk of PSA elevation increased 1.09 times as age increased, it was found that the risk did not show a significant change as creatinine increased (p<0.001 and p=0.99, respectively). Similarly, while the risk of moderate/severe eGFR decrease increased 1.11 times as age increased, it was found that the risk did not show a significant change as PSA increased (p<0.001 and p=0.31, respectively).
CONCLUSIONS: In the light of the findings of the study, it is concluded that the risk of increased PSA and creatinine levels increases with advancing age. The relationship between PSA and creatinine levels disappears and they do not effect each other when age variable is taken into account.

Anahtar Kelimeler

Prostate specific antigen, Prostate, Creatinine, Urea, Kidney disease

PROSTAT SPESİFİK ANTİJEN VE BÖBREK FONKSİYON TESTLERİ ARASINDAKİ İLİŞKİNİN NEDENİ: YAŞ

Öz

AMAÇ: İleri yaş erkeklerde sık görülmekte olan prostat ve böbrek hastalıklarının tarama, tanı ve tedavi takiplerinde kullanılmakta olan prostat spesifik antijen (PSA) ve kreatinin, tahmini glomerüler filtrasyon hızı (eGFR), üre ürik asit düzeyleri arasındaki ilişkilerin araştırılması amaçlandı.
GEREÇ VE YÖNTEM: Eylül 2017 – Mart 2020 tarihleri arasında 40 yaş ve üzerindeki 7203 erişkin erkek hastaya ait eş zamanlı olarak istenmiş olan serum PSA, kreatinin, üre ve ürik asit sonuçları retrospektif olarak incelendi. Parametreler arasındaki korelasyonlar yaşın etkisi ile birlikte değerlendirildi. Ek olarak PSA yüksekliği ile eGFR azalışı arasındaki çift yönlü ilişki de incelendi.
BULGULAR: Yaş değişkeni kontrol edildiğinde; PSA düzeyleri üzerine kreatinin, üre ve ürik asit düzeylerinin bir etkisi olmadığı (sırasıyla; p=0,63, p=0,28 ve p=0,39), benzer şekilde PSA düzeylerinin de kreatinin, üre ve ürik asit düzeyleri üzerine bir etkisi olmadığı gözlendi (sırasıyla; p=0,22, p=0,25 ve p=0,92). Yaş değişkeni ile birlikte yapılan regresyon analizlerinde; yaş arttıkça PSA yüksekliği görülme riski 1.09 kat artmakta iken kreatinin arttıkça ise riskin anlamlı bir değişim göstermediği tespit edildi (sırasıyla; p<0,001 ve p=0,99). Benzer şekilde yaş arttıkça orta ve ileri derecede eGFR azalış riski 1.11 kat artmakta iken PSA arttıkça ise riskin anlamlı bir değişim göstermediği tespit edildi (sırasıyla; p<0,001 ve p=0,31).
SONUÇ: Çalışmanın bulguları ışığında; yaş arttıkça PSA ve kreatinin düzeylerinin yükselme riski artarken, yaş değişkeni kontrol edildiğinde PSA ve kreatinin düzeyleri arasındaki ilişkinin ortadan kalktığı ve yüksekliklerinin birbirleri üzerine etkisinin olmadığı sonucuna ulaşıldı.

Anahtar Kelimeler

Prostat spesifik antijen, Prostat, Kreatinin, Üre, Böbrek hastalığı

Kaynakça

• 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
• 2. Aus G, Damber JE, Khatami A, Lilja H, Stranne J, Hugosson J. Individualized screening interval for prostate cancer based on prostate-specific antigen level: results of a prospective, randomized, population-based study. Arch Intern Med. 2005;165(16):1857-61.
• 3. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004;350(22):2239-46.
• 4. Schröder FH, van der Cruijsen-Koeter I, de Koning HJ, Vis AN, Hoedemaeker RF, Kranse R. Prostate cancer detection at low prostate specific antigen. J Urol. 2000;163(3):806-12.
• 5. Antenor JA, Han M, Roehl KA, Nadler RB, Catalona WJ. Relationship between initial prostate specific antigen level and subsequent prostate cancer detection in a longitudinal screening study. J Urol. 2004;172(1):90-3.
• 6. Kawachi MH, Bahnson RR, Barry M, et al. Prostate cancer early detection. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2007;5(7):714-36.
• 7. Emberton M, Andriole GL, de la Rosette J, Djavan B, Hoefner K, Vela Navarrete R. Benign prostatic hyperplasia: a progressive disease of aging men. Urology 2003;61(2):267-73.
• 8. Leão R, Pereira BJ, Coelho H (Edited by). Benign Prostate Hyperplasia and Chronic Kidney Disease. In: Monika Göőz. Chronic Kidney Disease. 1th Edition, Rijeka: InTech. 2012:347-70.
• 9. Nagamani SC, Erez A. A metabolic link between the urea cycle and cancer cell proliferation. Mol Cell Oncol. 2016;3(2):e1127314.
• 10. Keshet R, Szlosarek P, Carracedo A, Erez A. Rewiring urea cycle metabolism in cancer to support anabolism. Nat Rev Cancer. 2018;18(10):634-45.
• 11. Tan P, Shi M, Chen J, et al. The preoperative serum cystatin-C as an independent prognostic factor for survival in upper tract urothelial carcinoma. Asian J Androl. 2019;21(2):163-9.
• 12. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604-12.
• 13. Li R, Tang H, Bao T, Yang H, Jin T. Correlation between prostate-specific antigen and four renal function-associated parameters in different ethnicities in southwest China. Exp Ther Med. 2020;20(6):143.
• 14. Coppolino G, Bolignano D, Rivoli L, Mazza G, Presta P, Fuiano G. Tumour markers and kidney function: a systematic review. Biomed Res Int. 2014;2014:647541.
• 15. Emeje IP, Ukibe NR, Onyenekwe CC, Nnamah NK. Assessment of Serum Prostate Specific Antigen, Some Renal Indices and Uric Acid Levels in Subjects with Benign Prostatic Hyperplasia at Lokoja, Nigeria. J Bioanal Biomed. 2017;9(5):256-62.
• 16. Olubuyo AO, Adeleke AT, Olubuyo BO. Evaluation of Selected Renal Markers in Prostate Cancer. J Appl Sci Environ Manage. 2019;23(9):1725-8.
• 17. Rule AD, Lieber MM, Jacobsen SJ. Is benign prostatic hyperplasia a risk factor for chronic renal failure? J Urol. 2005;173(3):691-6.
• 18. Rule AD, Jacobson DJ, Roberts RO, et al. The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men. Kidney Int. 2005;67(6):2376-82.