Abstract: OBJECTIVE: To assess the effect and safety of Shengxuening(SXN), extract from excrement of bombyxin, in the treatment of renal anemia, compared to ferrous succinate and ferrous sulfate.METHODS: According to the participant, intervention, comparison, outcomes, study design(PICOS)principles, we searched the Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, Chinese Evidence-Based Medicine Database, Wanfang Database(From establishment to December 2014). Two reviewers selected articles independently according to the inclusion and exclusion criteria. The quality of included studies was assessed by using the Cochrane Handbook.All statistical analyses were conducted by using Revman(vision 5.2) software.RESULTS: A total of 14 randomized controlled trials(RCTs) were enrolled in the review. The results revealed that, when compared with blank group, SXN significantly improved the hemoglobin(P >) levels[MD = 6.29, 95% CI(1.65-10.94), P < 0.0008] and albumin(ALB) [MD = 10.98, 95% CI(6.97-14.99), P levels [MD = 10.98, 95% CI(6.97,14.99), P < 0.00001]. Compared with other oral medicine SXN could improve the P > levels effectively [MD = 8.49, 95% CI(2.40, 14.58), P = 0.006].And the subgroups analysis shown that compared with ferrous-sulfate there were significant differences [MD = 17.4, 95% CI(15.06, 19.73), P < 0.000 01]and the result of ferrous-succinate had significant differences [MD = 5.34, 95% CI(2.12, 8.56), P =0.001] too. Compared with Intravenous iron groups, there were statistical differences [MD =- 5.04, 95% CI(- 9.59,- 0.50), P = 0.03]. In the safety analysis, the rate of adverse reactions in SXN groups and control groups were 19.3% and 3.7%,respectively(P < 0.000 01). Due to our studies were of poor methodological quality, and the sample size were small, the results were influenced by bias.CONCLUSION: Our findings suggest that the SXN had better effect and was safer in the treatment of RA than ferrous succinate and ferrous sulfate.

Key words: Kidney failure, chronic, Anemia, Review, Shengxuening