A blood-cleaning procedure that filters the liquid part of blood through two membranes to remove large molecules such as antibodies, cholesterol-carrying particles, and clotting proteins. Best supported for rapidly lowering hard-to-treat cholesterol and removing harmful antibodies. Its longevity promise rests on thin, short-lived evidence; effects fade within days to weeks, and it remains experimental, expensive, and carries real risks. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Fibrinogen | 200–400 mg/dL | Tracks bleeding risk from clotting-protein removal |
| Prothrombin time / aPTT | Within lab reference | Detects overall coagulation impairment |
| Platelet count | 150–400 ×10⁹/L | Screens for consumption and heparin-induced drop |
| Hemoglobin / haptoglobin | Hb 13–15 g/dL (functional) | Detects hemolysis, the most common complication |
| Ionized calcium | 1.15–1.30 mmol/L | Guards against citrate-induced hypocalcemia |
| Serum albumin | 4.0–5.0 g/dL | Reflects protein status and hypotension risk |
| Immunoglobulin G | 700–1600 mg/dL | Monitors depletion and infection risk over a course |
| LDL cholesterol | <70 mg/dL (optimization target) | Confirms lipid-removal efficacy for lipid indications |
| Lipoprotein(a) | <75 nmol/L (<~30 mg/dL) | Primary target for Lp(a)-driven use |
| Triglycerides | <90 mg/dL (functional) | Efficacy and pancreatitis-risk marker |
| High-sensitivity CRP | <1.0 mg/L | Tracks inflammatory-load reduction |
| Electrolytes and kidney function (eGFR) | Within lab reference | Ensures safe fluid/citrate handling |
Cadence: Before and after every treatment, then periodically across a course — coagulation and calcium each session, a broader panel every few sessions