Simplification of an erythropoiesis model for design of anemia management protocols in end stage renal disease.
Simplification of an erythropoiesis model for design of anemia management protocols in end stage renal disease.
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DOI：
10.1109/iembs.2011.6089902
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Chait Y
中科院分区：
文献类型：
--
作者：
Nichols B;Shrestha RP;Horowitz J;Hollot CV;Germain MJ;Gaweda AE;Chait Y
许多终末期肾病（ESRD）患者由于内源性促红细胞生成素（EPO）生成不足而患有贫血。 30 多年前重组人 EPO (rHuEPO) 的发现使透析患者贫血的治疗从输血转向 rHuEPO 治疗。临床医生使用的许多贫血管理方案 (AMP) 包含一套基于经验的规则，用于根据血红蛋白 (Hgb) 测量值每周到每月滴定 rHuEPO 剂量。为了促进基于形式控制设计方法的 AMP 设计，我们提出了一种生理相关的红细胞生成模型，并表明可以使用静态非线性来近似其非线性动力学，这一步骤大大简化了 AMP 设计。我们使用临床数据证明了我们的结果的适用性。
Many end stage renal disease (ESRD) patients suffer from anemia due to insufficient endogenous production of erythropoietin (EPO). The discovery of recombinant human EPO (rHuEPO) over 30 years ago has shifted the treatment of anemia for patients on dialysis from blood transfusions to rHuEPO therapy. Many anemia management protocols (AMPs) used by clinicians comprise a set of experience-based rules for weekly-to-monthly titration of rHuEPO doses based on hemoglobin (Hgb) measurements. In order to facilitate the design of an AMP based on formal control design methods, we present a physiologically-relevant erythropoiesis model, and show that its nonlinear dynamics can be approximated using a static nonlinearity, a step that greatly simplifies AMP design. We demonstrate applicability of our results using clinical data.