Mechanisms of hemoglobin cycling in anemia patients treated with erythropoiesis-stimulating agents.

ABSTRACT: Patients with renal anemia are frequently treated with erythropoiesis-stimulating agents (ESAs), which are dynamically dosed in order to stabilize blood hemoglobin levels within a specified target range. During typical ESA treatments, a fraction of patients experience hemoglobin 'cycling' periods during which hemoglobin levels periodically over- and undershoot the target range. Here we report a specific mechanism of hemoglobin cycling, whereby cycles emerge from the patient's delayed physiological response to ESAs and concurrent ESA dose adjustments. We introduce a minimal theoretical model that can explain dynamic hallmarks of observed hemoglobin cycling events in clinical time series and elucidates how physiological factors (such as red blood cell lifespan and ESA responsiveness) and tre

SUBMITTER: Jorg DJ 

PROVIDER: S-EPMC9873166 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature