<h4>Aims</h4>This study aimed to synthesize the evidence of the comparative effectiveness and safety of <i>Ophiocordyceps sinensis</i> (<i>OS</i>) preparations combined with renin-angiotensin system inhibitors (RASi) for diabetic kidney disease (DKD).<h4>Methods</h4>Eight databases were searched from their inception to May 2023. Here, REN is linked to diabetic kidney disease.