Apheresis
Combined lipoprotein apheresis and hemodialysis cut cardiovascular events by 57% in 9 patients with severe cardiovascular disease and end-stage renal disease (J Clin Apher 2025)
Original title: Combined Treatment With Lipoprotein Apheresis and Hemodialysis in Patients With Severe Cardiovascular Disease, High Lipoprotein(a) and End Stage Renal Disease
This retrospective analysis examined 9 patients undergoing both lipoprotein apheresis (LA) and hemodialysis (HD) for severe cardiovascular disease with elevated Lp(a) and end-stage renal disease, a combination whose effect on outcomes had been unknown. Patients had been on HD for a median 4.2 years and on LA for a median 4.0 years; before starting LA, median Lp(a) was 242.67 nmol/L and mean LDL-C was 2.49 mmol/L. Each LA session produced mean acute reductions of 64.15% for Lp(a) and 57.26% for LDL-C. Adverse cardiac or vascular events fell from 14 before LA initiation to 6 afterward, a 57.2% reduction. The authors conclude LA appears effective at reducing cardiovascular events in this small cohort of dialysis patients with elevated Lp(a), while calling for larger studies to confirm the cardiovascular benefit of combined LA and HD treatment.
Original abstract
Elevated Lipoprotein(a) (Lp(a)) is a known independent cardiovascular risk factor. Lp(a) Lipoprotein Apheresis (LA) substantially reduces the number of cardiovascular events. The effect of LA treatment in hemodialysis (HD) patients remains unknown. Retrospective analysis of nine patients undergoing LA and HD. Cardiovascular risk factors and the efficacy of treatment were assessed. Adverse cardiac or vascular events (ACVE) were recorded. Median (range) years on HD were 4.2 (1.5 to 23.6) years and median years on LA were 4.0 (1.6 to 12.4) years. Before initiation of LA, median (range) Lp(a) level was 242.67 (164.0 to 400.10) nmol/L and mean LDL-C level (±SD) 2.49 (±1.14) mmol/L. Under treatment, mean acute reduction rates, comparing concentrations before and after LA sessions, were 64.15 (±5.45)% for Lp(a) and 57.26 (±7.93)% for LDL-C. Before initiation of LA, 14 ACVE occurred; after initiation, only 6 (57.2% reduction rate). In this small cohort, LA appears to be effective in reducing ACVE in patients on HD with elevated Lp(a) levels. Further studies are needed to evaluate the effect of LA on cardiovascular outcomes in dialysis patients.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.