Cochrane · systematic review · CD007857

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

O'Lone, EL, Hodson, EM, Nistor, I, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library

Kidney and Transplant2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 14.3%Low 12 · 85.7%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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Patient‐centred outcomes for oral versus IV iron in adults and children with chronic kidney disease

Population: adults and children with CKD
7 questions
OutcomeEffectEvidenceStatus / GRADE
Death (all causes)
Patient‐centred outcomes for oral vs IV iron
RR 1.12 [0.64, 1.94]11 studies · 1952 participantsLow
Downgraded: imprecision
Cardiovascular death
Patient‐centred outcomes for oral vs IV iron
RR 1.71 [0.41, 7.18]3 studies · 206 participantsVery low
Downgraded: imprecision
Type of adverse event: allergic reactions/hypotension
Patient‐centred outcomes for oral vs IV iron
RR 3.56 [1.88, 6.74]15 studies · 2607 participantsLow
Downgraded: imprecision
Type of adverse event: all gastrointestinal adverse effects
Patient‐centred outcomes for oral vs IV iron
RR 0.47 [0.33, 0.66]14 studies · 1986 participantsLow
Downgraded: imprecision, inconsistency, publication bias
Type of adverse event: infection
Patient‐centred outcomes for oral vs IV iron
RR 1.32 [0.9, 1.95]4 studies · 954 participantsLow
Downgraded: imprecision
Numbers of non‐dialysis patients needing to commence dialysis
Patient‐centred outcomes for oral vs IV iron
RR 0.81 [0.41, 1.61]4 studies · 743 participantsLow
Downgraded: imprecision
Number requiring transfusion
Patient‐centred outcomes for oral vs IV iron
RR 0.86 [0.55, 1.34]5 studies · 774 participantsLow
Downgraded: imprecision

Laboratory and pharmaceutical outcomes for adults and children with chronic kidney disease

Population: adults and children with CKD
7 questions
OutcomeEffectEvidenceStatus / GRADE
Number achieving target Hb or increase ≥1 g/dL
RR 1.71 [1.43, 2.04]13 studies · 2206 participantsLow
Downgraded: risk of bias
Hb: final or change (g/dL)
no estimate extracted31 studies · 3373 participantsLow
Downgraded: risk of bias
Ferritin: final or change (µg/L)
no estimate extracted33 studies · 3389 participantsLow
Downgraded: risk of bias
TSAT: final or change (%)
no estimate extracted27 studies · 3089 participantsLow
Downgraded: risk of bias
HCT (%)
no estimate extracted4 studies · 152 participantsVery low
Downgraded: risk of bias
ESA dose: final or change
no estimate extracted11 studies · 522 participantsLow
Downgraded: risk of bias
eGFR: final or change (mL/min)
no estimate extracted8 studies · 1052 participantsLow
Downgraded: risk of bias