中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (08): 670-674.doi: 10.3969/j.issn.1671-4091.2025.08.010

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口服吸附剂对慢性肾脏病或慢性肾功能不全患者的影响：一项系统评价和荟萃分析

韩佳苗    蒋 洁    李 文    孙 晶   

  1. 130022 长春，1吉林大学第二医院肾病内科
  • 收稿日期:2024-10-10 修回日期:2025-05-30 出版日期:2025-08-12 发布日期:2025-08-12
  • 通讯作者: 孙晶 E-mail:s_jing@jlu.edu.cn

Effects of oral adsorbents on patients with chronic kidney disease or chronic renal insufficiency: a systematic review and meta-analysis

HAN Jia-miao, JIANG Jie, LI Wen, SUN Jing   

  1. Department of Nephrology, The Second Hospital of Jilin University, Changchun 130022, China
  • Received:2024-10-10 Revised:2025-05-30 Online:2025-08-12 Published:2025-08-12
  • Contact: 130022 长春，1吉林大学第二医院肾病内科 E-mail:s_jing@jlu.edu.cn

摘要： 目的  评估口服吸附剂类药物在慢性肾脏病或慢性肾功能不全患者中的疗效和安全性。 方法  在The Cochrane Library、PubMed、Web of Science、Embase、CNKI、Wanfang、VIP、SinoMed数据库上对相关随机对照研究进行系统检索。采用Cochrane偏倚风险评估工具(risk-of-bias tool,RoB2)对纳入的研究进行质量评价。采用Stata 15.0和Stata 16.0软件进行Meta分析。 结果  27项随机对照试验共纳入2569例患者，与对照组比，试验组总疗效(RR =1.643，95% CI：1.405～1.920,P＜0.001)、血肌酐(SMD=-0.545，95% CI：-0.643～-0.448,P＜0.001)、血尿素氮(SMD=-0.756，95% CI：-0.972～-0.541,P＜0.001)等结局指标更优，且未增加不良反应(RR=0.741，95% CI：0.512～1.073，P=0.113)。预设亚组分析(短期比长期干预)显示，短期(＜2个月)干预中，肌酐、血尿素氮、24 h尿蛋白定量、肌酐清除率等疗效指标改善显著)，长期(≥2个月)干预中，口服吸附剂类药物旨在维持疗效，并无更多提升疗效的作用。 结论  与常规治疗相比，慢性肾脏病或慢性肾功能不全患者口服吸附剂类药物可能会延缓肾功能恶化，同时并未增加相关药物不良反应发生率。

关键词: 慢性肾脏病, 慢性肾功能不全, 口服吸附剂, AST-120, 尿毒清颗粒, 爱西特

Abstract: Objective  To evaluate the efficacy and safety of oral adsorbent agents in patients with chronic kidney disease (CKD) or chronic renal insufficiency.   Methods   A systematic search of randomized controlled trials (RCTs) was conducted in The Cochrane Library, PubMed, Web of Science, Embase, CNKI, Wanfang, VIP, and SinoMed databases. Quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB2). Meta-analysis was performed using Stata 15.0 and Stata 16.0 software.  Results  A total of 27 RCTs involving 2,569 patients were included. Compared to the control group, the treatment group showed significantly better outcomes in terms of overall efficacy (RR=1.643, 95% CI:1.405～1.920, P＜0.001), serum creatinine (SMD=-0.545, 95% CI: -0.643～-0.448, P＜0.001), and blood urea nitrogen (SMD=-0.756, 95% CI: -0.972～-0.541, P＜0.001), without an increased incidence of adverse reactions (RR=0.741, 95% CI: 0.512～1.073, P=0.113). Pre-specified subgroup analysis (short-term vs. long-term intervention) revealed that in the short-term (＜2 months) indicators such as serum creatinine, blood urea nitrogen, 24-hour urinary protein quantification, and creatinine clearance improved significantly. In contrast in long-term intervention (≥2 months), oral adsorbents mainly served to maintain efficacy without further therapeutic improvement.   Conclusion  Compared with conventional treatment alone, oral adsorbent agents may help delay renal function deterioration in patients with chronic kidney disease or chronic renal insufficiency, without increasing the incidence of drug-related adverse events.

Key words: Chronic kidney disease, Chronic renal insufficiency, Oral adsorbents, AST-120, Niaoduqing granules, Aicit

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