Iron dextran 100mg/2ml solution for injection ampoules

ObjectiveThis meta-analysis, combined with trial sequential analysis (TSA), aimed to evaluate the effects of probiotics on hematologic parameters and iron-regulation biomarkers in Chinese children with iron deficiency anemia (IDA).MethodsTen electronic databases were systematically searched for eligible studies published up to April 30, 2026. Meta-analyses were conducted using RevMan (version 5.3), and TSA was performed with TSA software (version 0.9.5.10 beta). Dichotomous and continuous outcomes were pooled as risk ratios (RRs) and mean differences (MDs), respectively. Publication bias was assessed using Egger's and Harbord's tests.ResultsTwelve randomized controlled trials involving 1,342 children with IDA were included. In terms of efficacy, probiotics significantly increased hemoglobin (Hb) (MD 8.64 g/L, 95% CI 6.77-10.52), red blood cell (MD 0.47 × 1012/L, 95% CI 0.19-0.76), mean corpuscular hemoglobin concentration (MD 15.66 g/L, 95% CI 12.55-18.77), mean corpuscular volume (MCV) (MD 6.68 fL, 95% CI 4.69-8.67), mean corpuscular hemoglobin (MD 2.40 pg, 95% CI 1.57-3.22), and hematocrit (MD 3.36%, 95% CI 2.31-4.41), serum iron (MD 1.70 μmol/L, 95% CI 0.89-2.51), and serum ferritin (MD 5.62 μg/L, 95% CI 4.24-7.00), while significantly reducing transferrin levels (MD - 0.24 g/L, 95% CI -0.34 to -0.15). Regarding safety, probiotics significantly reduced the incidence of total adverse events (RR 0.52, 95% CI 0.28-0.97), with no significant effects observed on anorexia, nausea and vomiting, metallic taste, abdominal pain, diarrhea, or constipation. TSA demonstrated that all positive outcomes, except total adverse events, reached the required information size and were conclusive. No significant publication bias was detected for most outcomes. Although publication bias was observed for MCV, trim-and-fill analysis confirmed the robustness of the pooled effect estimate. The evidence certainty of all outcomes was low or very low.ConclusionProbiotics may improve anemia-related parameters and iron metabolism in Chinese children with IDA. However, the pooled increase in Hb remains below the minimal clinically important difference, and evidence on total adverse events remains inconclusive. Therefore, probiotics should be considered as an adjunct to oral iron supplementation rather than a standalone intervention. These findings should be interpreted with caution due to potential biases and the inclusion of only Chinese children.

Abstract licence: CC BY

Key pointsIron deficiency is common in patients with AKI. It is unknown whether treating iron deficiency in AKI with intravenous iron reduces the risk of major adverse kidney events. In AKI and iron deficiency, intravenous iron did not reduce the risk of major adverse kidney events at 90 days.BackgroundDuring AKI, iron deficiency may contribute to worse clinical outcome by interfering cellular repair. Correcting iron deficiency with intravenous (IV) dextran iron may reduce the risk of major adverse kidney events (MAKEs). We aimed to assess whether IV iron was more efficacious than conventional management for reducing MAKE in patients with AKI-iron deficiency.MethodsIn a phase 2 randomized controlled trial, from July 2022 to September 2024, patients with AKI and iron deficiency (iron levels ResultsThe primary outcome MAKE90 occurred in 48 patients in the IV iron group and 47 in the control group (82% versus 75%; P = 0.37). Individual components of MAKE were similar in both groups, 36 (62.1%) versus 38 (61.3%) had worsened kidney function, 14 (24.1%) versus 13 (21%) initiated KRT, and mortality was 43.1% and 38.7% in the IV iron and control groups, respectively ( P ≥ 0.05 for all). Hemoglobin values and adverse events did not differ between groups during the study.ConclusionsIn patients with AKI and iron deficiency, a single dose of IV iron, compared with usual care, did not improve clinical outcomes evaluated by MAKE90, the hemoglobin value, but was safe.Clinical trial registry name and registration numberClinicalTrials.gov, ID: NCT05960227 registered September 19, 2022, Institutional Review Board approval 159/22.

Abstract licence: CC BY-NC-ND