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