Tumor Markers in Patients Undergoing Hemodialysis and Kidney Transplantation

Objective: To evaluate the effect of dialysis and kidney transplantation on serum levels of several tumor markers such as PSA, AFP, CA125, CA19- 9, CA15-3, CEA and to compare with normal age matched controls. Methods: Between September of 2000 and July of 2001, the following tumor markers: PSA, AFP, CA125, CA19-9, CA15-3 and CEA were measured by ELISA Method in 29 hemodialyzed patients (group A), in 30 successfully transplanted patients (group B) and in 30 normal volunteers who did not present any clinical symptoms or signs of neoplasia. Results: The serum level of CEA was above the cutoff limit in 6.7% of hemodialyzed patients (group A) but was in the normal range in transplanted and control groups. The level of CEA were significantly higher in hemodialyzed patients in comparison to other groups (p<0.003). Serum levels of AFP and PSA were not significantly different between the three groups (p=0.595 and p=0.545, respectively). Although serum level of CA 19-9 was elevated in 3.3% of hemodialyzed and control group the differences between the three groups were not significant (p=0.507). Serum level of CA 125 was elevated in 13.3% of group A, 13.8% of group B and 6.7% of control group (p=0.347). Serum level of CA15-3 was elevated in 13.3%, 6.9% of group A, B and control group, respectively and the differences were not significant (p=0.156). Conclusion: Hemodialyzed and transplanted patients show a high false positive rate of CEA, CA125 and CA15-3 and may be unreliable for monitoring of malignancies in these patients while other markers evaluated (AFP, PSA and CA 19.9) appear to maintain their specificity in these situations.