Effects of Erythropoietin: A Quantitative Approach

What is the research problem? 

The application of Erythropoietin-stimulating agents (ESA) to care for renal anemia patients without applying the blood purifying machine has escalated blood pressure cases. 

What is the study purpose? Is it stated? 

The study describes the outcome of the perpetual response to sensory stimuli following the erythropoietin inciters. The blood pressure of 36 patients who had received ESA treatment in the absence of blood purifying machines was investigated. The research specialists modified the measured portions of ESA preserved to be taken in adherence to the prescription. The doses were modified to retain hemoglobin recommendations. The research subjects were entitled to the treatments for six months, after which ambulatory blood pressure was recorded among them. Also, the hemoglobin levels maintained the spectrum in the period. 

Is the purpose consistent with the quantitative design? Compare with the textbook. 

The research purpose is consistent with the quantitative design because it has been established upon gathering and evaluating numerical information of the patients and treatments involved. Also, the purpose has demonstrated, illustrated, and foretold the underlying phenomena and made the management of variables easy. Moreover, the researchers were interested in manageable variables that can be measured. 

What topics are reviewed? Does the review provide an up-to-date synthesis of evidence on the research problem? 

The literature review covered two main topics. However, the synthesis of evidence did not provide an up-to-date review of the research problem since most of the reviewed articles were more than ten years ago. 

Erythropoietin-Stimulating Agents and Renal Anemia 

By concept, Erythropoietin refers to a hormone secreted by the kidney and is utilized in the manufacturing of red blood cells. In contrast, Erythropoietin-stimulating agents are mostly utilized for individuals with lasting kidney infections and anemia. The manufacturing of more red blood cells by Erythropoietin increases the amount of hemoglobin responsible for transporting oxygen from the lungs to all body parts and carbon dioxide from the body parts to the lungs. If the amount of hemoglobin in the body is low, a person will likely suffer from anemia. 

One study employed recombinant erythropoietin drug, otherwise referred to as erythropoietin-stimulating agents, by injection to the patients who disregarded transfusions. The study established that high blood pressure was an adverse condition related to the drugs. 

Comparison of CERA with DA 

Continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) is the existing EPO agents with lasting effects, but they do not compare with regards to effectiveness. In this case, one study employed the two to treat dialysis patients with anemia. It established that the dosage and hemoglobin concentration of the two EPOs was equal, and therefore, they could be employed interchangeably. 

What criteria and methods were used to select a representative and unbiased sample? Compare with the textbook. 

The study employed the simple random sampling technique to select participants among the homogenous population. The population included stage G3- G5 CKD patients whose treatment did not include ESA and were no receiving attendance on renal anemia dialysis. The research’s inclusion criteria were also characterized by patients aged 20 years and above, and their hemoglobin level was less than 11 g/dL. In the converse criteria, all the patients who had received ESA treatments within the three months before the study were excluded. Moreover, those who had undergone red blood cell transfusions some four months before the study were excluded (Ohki et al., 2020) . Patients with regular heart disorders, breastfeeding and pregnant women, and myocardial and stroke patients were excluded from the study. 

Was the sample size adequate based on power analysis or other criteria? Compare with the textbook. 

The sample size was adequate based on inclusion and exclusion criteria. It included adults of 20years and above whose decision could be trusted as well informed. Moreover, the sample size included homogenous patients and shunned those who had regular heart failures. This way, the results of the study would be consistent, and bias would be avoided. 

Were participants’ rights protected? Are IRB approval and consent mentioned? 

The participants’ rights were protected since the study ensured that every step that included human subjects respected the organization’s ethical principles. Besides, the study was scrutinized by the review board in charge of the rights of human participants before it was conducted. The study was also monitored and approved by the Institutional Review Board. 

What instruments were used? What variables were measured? 

The instruments used for the study included a calibrated standard mercury sphygmomanometer that was employed to determine the ambulatory blood pressure. Sensors were also employed to determine the waveforms on the brachial artery. 

The study measured dependent variables such as the blood pressure of the participants. The measurement was obtained at two minutes’ intervals, and the average of the values was determined as the ambulatory blood pressure. 

What procedures were used to gather data? Are the data collection procedures consistent with the method? Compare with the textbook. 

The information of the research was collected after conducting a six-month experiment on the randomly selected participants. The subjects received a DA injection therapy on the fatty layer of their skin. A hypertensive therapy was also conducted to establish the objective of the ambulatory blood pressure. 

Were appropriate statistical analysis methods used? (describe the statistical test used to analyze the study question). Compare with the textbook. 

The information was represented as positive and negative mean standard deviation. The study also appropriately analyzed data in percentage or milligram statistical modes. The spectrum of the dependent variables and independent variables was regarded to evaluate the distinction of the CERA and DA classifications (Ohki et al., 2020) . Moreover, a grouped p test was employed to evaluate the contrasting effects noted at the onset of the study and the end of the six months of experimentation. Specialized software was also utilized to evaluate the statistics, and a value ranged less than 0.05 was regarded as a crucial statistical denotation. 

Summarize the findings of the study. (Take a home message and p -value stated) 

The study’s fundamental realizations were an established boundary between ambulatory blood pressure and office blood pressure. The short-term variableness of the blood pressure was determined after the six months of treating the ESA, and the differences across the CERA and DA sets were established. Also, the renal function representations, the outcome of ESA on upholding the HB levels, and the population of the clients who deserved dialysis were evaluated. The evaluation of various side effects registered from the experiment was also conducted concerning CERA and DA sets treatment occurrence period. 

What content is covered in tables and figures? Is the summary of findings clear with good use of tables and figures? 

The content covered in tables and figures includes the evaluation of similarities and differences between the ambulatory blood pressure in the CERA set and the DA set that were registered at the close of six months of the study. Besides, the similarities and differences between BMI, office blood pressure, the performance of the vascular, escalation of the antihypertensive advocacies, and the laboratory establishment in the CERA and DA sets evaluated at the end of the six months ESA experimentation is contained in the tables. The measured portions of ESA compared with the administration occurrences in the two distinct sets are also represented on the tables. Another table also depicts the characteristics of the phenomena at the onset of the study. It reflects the traits of the patients and the conditions that are included in the study. 

What implications are discussed by the researcher? 

The study examines the blood pressure utilizing ABPM in Erythropoietin-stimulating agent’s experimentation. The study implies that renal anemia develops due to the decline in the secretion of Erythropoietin attributed to dysfunction of renal performance and exposes the victim to cardiovascular infections. Accordingly, the study tries to establish the outcome of curative indulgences regarding ESAs in clients lacking dialysis renal anemia in curtailing the perpetuity of cardiovascular infections (Ohki et al., 2020) . The researcher also implies that the outpatient blood pressure is suitable for suitable examination of hypertension and approximation of blood pressure management. The specialists advocate for Ambulatory blood pressure management in forecasting the harmfulness of cardiovascular infections and demises instead of the pressure gauging devices for CKD patients. 

Do the implications for practice have applicability in your practice? What do you think? 

The study’s implications concerning the ESAs can be widely applied in my clinical practice to advance the attainment of optimal healthcare for the clients and shun major adverse transfusions. The establishment can be employed in preventing and providing care for renal anemia in non-dialysis patients.