Thematic Area: Lipids

Expert Recommendation

 

Clinical practice recommendations on lipoprotein apheresis for children with homozygous familial hypercholesterolemia: an expert consensus statement from ERKNet and ESPN

Reference: Reijman et al, Atherosclerosis, Volume 392, May 2024, 117525. https://www.atherosclerosis-journal.com/article/S0021-9150(24)00085-6/fulltext

PDF: See here

Collaboration: ERKNet/ESPN­­


Highlights:

 

  • Early intervention is vital to prevent cardiovascular disease in homozygous familial hypercholesterolaemia (HoFH).

  • This consensus statement provides guidance on performing lipoprotein apheresis in children with HoFH.

  • Using the Delphi method involving 40 international experts, 22 statements were developed.

  • Statements cover indication, methods, treatment goals and follow-up of lipoprotein apheresis in children with HoFH.

  • Furthermore, the role of lipoprotein(a) and liver transplantation in children with HoFH is discussed.

 

 

KDOQI Clinical Practice Guideline for Nutrition in Children with CKD: 2008 update (statements regarding lipids)

Reference: KDOQI Work Group. Am J Kidney Dis. (2009). doi: 10.1053/j.ajkd.2008.11.017


Core Recommendations:

  1. Lipid profiling (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides) is recommended on an annual basis  
  2. Treatment with statins or statin/ezetimibe combination is not routinely recommended  

Comments by evaluators:

  • No parent or patient representatives, renal nurses or Play Specialists or support workers involved
  • Rigorous guideline development process, but very little data in children, so largely opinion based recommendations
  • Excellent guideline with a great deal of detail, but application 'on the shop floor' may be difficult