Safety and Efficacy of Iron Chelators in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

作者：Rajha HE, Shamoon R, Almeshagbeh A, Masry S, Alqatati F, Abuajameia BH, Nashwan AJ · 发表于：Hemodialysis international. International Symposium on Home Hemodialysis · 年份：2026 · DOI：10.1111/hdi.70103 · 研究领域：chronic kidney disease、deferasirox、deferoxamine、iron chelation、iron overload、meta‐analysis、systematic review

BACKGROUND: Iron overload in chronic kidney disease contributes to oxidative injury. The role of iron chelators, standard in transfusion-related overload, remains unclear in chronic kidney disease. AIM: To evaluate the efficacy and safety of iron chelators in adults with chronic kidney disease. METHODS: A systematic review and meta-analysis followed PRISMA 2020 guidelines. Databases were searched for randomized controlled trials and observational studies reporting on iron indices, hematological parameters, and adverse events. RESULTS: Eleven studies (206 patients) were included. Iron chelation significantly reduced serum ferritin (weighted mean difference [WMD]: -1.48 μg/L; 95% CI: -2.09, -0.87), transferrin (WMD: -10.6 mg/dL; 95% CI: -15.6, -5.61), and serum iron (WMD: -24.2 μg/dL; 95% CI: -42.5, -5.9). Hemoglobin increased (WMD: 1.07 g/dL; 95% CI: 0.20, 1.94). Glucose levels decreased, but lipid parameters were unaffected. Evidence was limited by high heterogeneity and potential bias. Gastrointestinal adverse events were common; serious events were rare. CONCLUSION: Iron chelation effectively reduces iron stores and may improve anemia in chronic kidney disease patients. However, the evidence is limited by small sample sizes and heterogeneity. High-quality randomized controlled trials are needed to establish clinical utility and safety before routine use.