Metabolic acidosis is a common complication of
chronic kidney disease (CKD).
Veverimer is an orally administrated, free
amine polymer with high capacity and binding selectivity to
hydrochloric acid from the gastrointestinal tract. This study pooled the current evidence of the efficacy and safety of
veverimer for the treatment of
metabolic acidosis associated with CKD. We conducted a systematic literature search on PubMed, Embase, and Cochrane Central for relevant randomized controlled trials (RCTs) in June 2020. In this study, three RCTs with 548 patients were included in our analysis. The analysis revealed that
veverimer was associated with increased
bicarbonate level of patients (weight mean difference [WMD] 3.08, 95% confidence interval [CI] [2.40, 3.77], p < 0.001) and improved physical function compared with placebo measured by
Kidney Disease and Quality of Life Short Form 36, question 3 (physical functioning domain) (KDQoL-PFD) score (WMD 5.25, 95% CI [1.58, 8.92], p = 0.005). For safety outcomes, both groups exhibited similar risks for developing
headache,
diarrhea,
flatulence, and
hyperkalemia. In conclusion, current clinical evidence indicates that
veverimer is efficacious and safe against
metabolic acidosis related to CKD compared with placebo. Further research comparing long-term
veverimer use with traditional
alkali therapy is needed.