Kinetic analysis of cholesterol removal by thermofiltration.
Excellent prediction of post treatment lipid concentrations using a simple one-compartment kinetic model was shown. Higher plasma filter sieving coefficients for total cholesterol and LDL cholesterol were obtained from healthy volunteers, suggesting that in hypercholesterolemic patients the LDL fraction has a larger mean particle size. The difference in plasma filter sieving coefficients for apoprotein B and LDL cholesterol indicates a large heterogeneity in LDL particle sizes. The HDL cholesterol post treatment concentration decreased an average of 30% compared with the pretreatment concentration. However, because the total drop in cholesterol concentration was about 60%, the ratio of HDL cholesterol to total cholesterol improved substantially. Removal of LDL and total cholesterol closely approximated the theoretic 100% removal line representing plasma exchange, and a high return of HDL cholesterol was achieved. The simple kinetic model can be used for treatment planning (calculation of plasma volume to be processed) to achieve the desired post treatment macrosolute concentrations.
Malchesky
P S
PS
Department of Artificial Organs, Cleveland Clinic Foundation, OH 44106.
Werynski
A
A
Nomura
H
H
Yamashita
M
M
Takeyama
Y
Y
Nosé
Y
Y
D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000150:complications; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006358:Hot Temperature; D006801:Humans; D006937:Hypercholesterolemia / Q000209:etiology / Q000628:therapy*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010956:Plasmapheresis / Q000379:methods*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL