Objective 　To assess the efficacy and safety of prescribing medicinal charcoal for treatment of adult chronic kidney disease.
Methods 　We searched the Cochrane Controlled Trial Register (The Cochrane Library Issue 1, 2009), MEDLINE (1950 to January 2009), EMbase (1980 to January 2009), and Chinese Biomedical Database (1977 to January 2009) to screen randomized controlled trials (RCTs) concerning use of medicinal charcoal for treatment of adult chronic kidney disease. We evaluated the bias risk of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 4.2.2.The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis.
Results 　Seven trials involving 347 patients met the criteria. Meta-analysis showed: (1) Medicinal charcoal was better than routine treatment on the improvement of blood urea nitrogen [MD= –0.69, 95%CI (–1.13, –0.24), P=0.002], serum creatinine [MD= – 0.51, 95%CI (–0.94, – 0.08), P=0.02] and the mean change of glomerular filtration rate per month (P lt;0.001). Compared with routine treatment, medicinal charcoal had similar effects on the improvement of 24 hours urinary protein and the mean change of blood pressure; (2) Compared with placebo, and medicinal charcoal was not superior to placebo in improving the incidence of end stage kidney diseases, serum creatinine, creatinine clearance rate, 24 hour urinary protein (P gt;0.05); (3) Adverse events with constipation, flatulenceand nausea occurred to medicinal charcoal groups.
Conclusion 　Overall, the evidence is not b enough, and more large, high-quality randomized controlled trials are needed to confirm or refute the available evidence.

Citation： SUN Hongjuan,WU Hongmei,WANG Feng,LI Ting. Medicinal Charcoal for Chronic Kidney Disease: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(12): 1310-1314. doi: 10.7507/1672-2531.20090239 Copy