Figure 2.
Mechanism for the EPO surge after IVHD in participants with CMS. IVHD replaces a fraction of blood with fluid, raising fractional plasma volume, and glomerular filtration. The reduction in red cell count reduces oxygen delivery to the kidney; higher glomerular filtration increases oxygen demand imposed by tubular transport. Both factors conspire to reduce PO2 levels at the sensor (peritubular interstitial fibroblasts) driving EPO production.
