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Lipid-apheresis is an indispensable treatment for patients with:
- Severe hyperlipidemia
- Drug intolerance or incompatibility to lipid lowering drugs
- High risk profile of atherosclerosis or ischemic cardiovascular disease
Lipid-apheresis is highly efficient for patients, who do not tolerate medication therapy or do not reach the therapy target lipid level by medication only.
But what does Hyperlipidemia actually mean?
Hyperlipidemia or Hyperlipoproteinemia is a metabolic disorder in which the plasma levels of LDL-cholesterol, Triglycerides and Lipoproteins are elevated. One distinguishes between Hypercholesterolemia, Hypertriglyceridemia and Combined Hyperlipidemia.
The role of cholesterol
First of all, there are two main subclasses when we are talking about cholesterol: LDL-cholesterol and HDL-cholesterol. LDL stands for Low Density Lipoprotein. LDL-cholesterol is also famous as the “bad” or “dangerous” cholesterol. However, the human body needs LDL-cholesterol for the production process of new tissue, hormones and bile acid in the liver. Therefore, the body produces LDL-cholesterol in the liver by around 70%. The rest is assimilated by diet, thereof exclusively by animal fats. LDL-cholesterol becomes bad if a normal level is exceeded.
HDL stands for High Density Lipoprotein. It is produced exclusively by the body in the liver and intestine. HDL-cholesterol is known as the good one, since it plays a crucial role in the reverse cholesterol transport of excess LDL-cholesterol from the tissue back to the liver. The liver is the organ where the LDL-cholesterol is metabolized.
The LDL-cholesterol plasma level is elevated in this form of dislipidemia. The reason for Familial Hypercholesterolemia (FH) is genetically determined and leads to LDL receptor mutation or to a mutation in the lipoprotein ApoB of LDL-cholesterol. Hereby, LDL-cholesterol cannot be broken down anymore by the liver.
Lipoprotein a (Lp(a)), which is similar to LDL-cholesterol, can also be elevated.
Both are independent risk factors for atherosclerosis.
Triglycerides are belonging as well to the group of lipids and are the main component of the dietary fats. Additionally, they are produced by the human body itself. Triglycerides serve as the most important energy depot, saved as body fat. Exceeded energy from sugar and alcohol, for example, are metabolized into triglycerides and then saved as body fat. Furthermore, triglycerides are an important component of cell membranes, enzymes and hormones.
If the plasma level of triglycerides is elevated, one speaks of hypertriglyceridemia, a disorder of the lipid metabolism.
The Combined Hyperlipidemia
Elevated LDL-cholesterol and triglyceride plasma levels lead to combined hyperlipidemia.
Causes and risk factors of dislipidemia
Different risk factors can be involved in the development of dislipidemia.
Lifestyle (diet too rich of calories and highly saturated fats, physical inactivity, smoking)
Certain disorders (Diabetes mellitus, hypertension, renal insufficiency or thyroid underfunction)
Hereditary diseases (homozygous – inherited by both parents, heterozygous – inherited by one parent)
How to treat dislipidemia
First of all change of lifestyle is highly recommended accompanied to medication. If the maximal tolerable medication does not lead to the required treatment targets and a progression of atherosclerosis is detected, the lipid apheresis is the treatment of choice on the top of the medication.
How frequently has the treatment to be carried out?
It depends on the severity of the lipid-disorder and the treatment target level depending on the risk profile. In most cases a treatment frequency of weekly or biweekly is sufficient. One treatment session takes about 1.5-3 hours and is performed as outpatient care.
Is the apheresis procedure reliable?
The Liposorber® treatment conducted for the last 20 years and therefore fulfills highest requirements. The treatment modality can be individually adjusted. It does not hurt, besides the usual needle puncture in the vein.