yemenjmedYemen Journal of MedicinecoVolume 5 Issue 1MultidisciplinaryEnglishJanuary- April 2026NNY2026047ArticleIron Therapy for Anemia in Diverse Populations: An Umbrella Review of Systematic ReviewsEnglishY00ElmukhtarHabasEnglishNAmlHabasEnglishYHafedhGhazouaniEnglishYAlaHabasEnglishYEshrakHabasEnglishYAmnnaRayaniEnglishY10.63475/yjm.v5i1.0296Iron deficiency anemia is a common condition seen in several demographics, including the general population, those with chronic kidney disease (CKD), those with acute kidney injury (AKI), patients dependent on dialysis, and kidney transplant recipients. This umbrella review synthesizes data only from published systematic reviews and meta-analyses to evaluate the efficacy and safety of iron therapy for chronic and acute anemia in these populations. The evaluation compared intravenous (IV) and oral iron supplementation, concentrating on hemoglobin response, cardiovascular outcomes, and related comorbidities. Data from 45 systematic reviews and meta-analyses demonstrate that in the general population, alternate-day oral iron has equivalent efficacy to daily dosing, while resulting in fewer adverse effects. The evidence for iron therapy in AKI is limited and suggests potential negative consequences from supplementation, while chelation may provide therapeutic benefits. Still, high-quality data on AKI are lacking. IV iron is often more efficacious than oral iron in elevating Hb levels, particularly in patients with CKD and those receiving dialysis, with risk ratios for achieving target Hb levels ranging from 1.23 to 1.71. Iron supplementation after transplantation enhances anemia; nonetheless, appropriate procedures remain undetermined. In terms of safety, IV presents a risk of hypersensitive reactions (relative risk [RR], 3.56 [95% CI, 1.88–6.74]) in contrast to oral iron. However, the absolute risk with modern formulations is low (0.1%–0.5%). Conversely, oral iron is linked to gastrointestinal side effects; IV iron reduces gastrointestinal events by 53% compared to oral iron (RR, 0.47 [95% CI, 0.33–0.66]). IV iron decreases hospitalizations for heart failure (RR, 0.77) in CKD, while it may increase the risk of serious adverse events under certain conditions. Therefore, it can be concluded that there is a need for personalized iron therapy to improve both efficacy and safety. Future research should prioritize high-quality trials in AKI and standardized protocols in transplantation.EnglishIron therapy, intravenous iron, oral iron, anemia, dialysis, iron deficiency anemia, CKD, AKI, kidney transplantationhttps://yemenjmed.com/admin/abstract?id=352References1619