Parenteral versus oral iron therapy for adults and children with chronic kidney disease

Summary

A Cochrane review «Parenteral versus oral iron therapy for adults and children with chronic kidney disease»1 «O'Lone EL, Hodson EM, Nistor I et al. Parenteral versus oral iron therapy for adults and children with chronic kidney disease. Cochrane Database Syst Rev 2019;(2):CD007857. »1 included 39 studies with a total of 3852 subjects. IV iron compared with oral iron may increased the number of participants who achieved target haemoglobin (table «Oral versus IV iron in adults and children with chronic kidney disease»1), increased haemoglobin (MD 0.72 g/dL, 95% CI 0.39 to 1.05; 31 studies, n=3373), ferritin (MD 224.8 μg/L, 95% CI 165.85 to 283.83; 33 studies, n=3389), and transferrin saturation (MD 7.69%, 95% CI 5.10 to 10.28; 27 studies, n=3089). There was a significant reduction in erythropoiesis-stimulating agent (ESA) dose in patients receiving dialysis who were treated with IV iron. Heterogeneity among studies remained largely unexplained, but was likely to be related to the significant variation in the relative doses of IV and oral iron used in each study. Mortality and cardiovascular mortalitydid not differ significantly (table «Oral versus IV iron in adults and children with chronic kidney disease»1). Gastrointestinal side effects were more common with oral iron, but hypotensive and allergic reactions were more common with IV iron.