Mechanisms of hemoglobin cycling in anemia patients treated with erythropoiesis-stimulating agents
Fig 5
Variability in hemoglobin and ESA administration dynamics for a simulated example patient and treatment setting, where individual physiological and treatment parameters are varied.
(A) Mean distance of the ground-truth Hb levels to the specified Hb target range (10–11 g/dL) if RBC lifespan is varied and all other physiological, treatment and ESA parameters are fixed. (A’) Fraction of time the patients spends with Hb levels below the target window and (A”) above the target window as a function of RBC lifespan. In panels A–A”, the red shaded region indicates where RBC lifespan is so small that even repeated administration of the maximum ESA dose cannot achieve Hb target levels, see Eq (15); in the green shaded region, RBC lifespan is high enough to maintain Hb target levels even without ESA therapy, see Eq (16). (B–D”) Contour plots show the indicated quantities if two parameters are varied simultaneously. Columns are organized by quantity displayed and rows are organized by pair of parameters varied. The white line in panels B–B” indicates the cross section of the plot that is displayed in panels A–A”, respectively. Parameters not indicated are fixed to the values provided in Table 1.