2002 Volume 35 Issue 11 Pages 1441-1446
LDL apheresis was introduced to severe ASO patients on chronic hemodialysis and its clinical efficacy was examined.
Nine patients (7 diabetic, 2 non-diabetic) receiving chronic hemodialysis showed lower extremity grade IV ulcer by Fontaine classification. Observation of lower extremity X-ray showed vascular calcification. All cases resisted all other treatments, including anti-platelet drugs, prostaglandins and revasculrization.
They received total of 10 sessions of LDL apheresis, which was performed synchronously with hemodialysis to lighten the burden on the patients. On examination, significant decreases were noted in total cholesterol, LDL cholesterol and apoprotein B after LDL apheresis. Clinical efficacy was as follows: three patients were cured of the ulcer at 3 months follow-up, and 2 were cured at 1.8 years follow-up. LDL apheresis improved the patients' lipid profile but the therapy efficacy was not related to improvement. Although the precise mechanism of this therapy is unknown, LDL apheresis treatment is worth considering for severe ASO patients on chronic hemodialysis.
