A widely used constipation medication may have an unexpected kidney-protective effect
Chronic kidney disease (CKD) affects people worldwide and often advances to a stage where regular dialysis becomes essential for survival. Despite the seriousness and prevalence of CKD, there are no approved drugs that can actively restore damaged kidney function. A research team led by Professor Takaaki Abe from the Tohoku University Graduate School of Medicine has identified a surprising approach: repurposing a constipation remedy. Their findings show, for the first time, that lubiprostone can slow the decline of kidney function in CKD patients.
But here's where it gets interesting: constipation is frequently observed in CKD, prompting scientists to explore whether treating it could influence kidney health. Abe explains, “Constipation disrupts the gut microbiota, which in turn can worsen kidney function. By addressing constipation, we hypothesized that kidney function could improve.”
Clinical Trial Demonstrates Lubiprostone’s Kidney-Sparing Effect
To test this hypothesis, the team conducted a multicenter Phase II clinical trial (LUBI-CKD TRIAL) across nine medical centers in Japan. The study enrolled 150 participants with moderate CKD and compared the impact of lubiprostone against a placebo. Participants receiving 8 µg or 16 µg of lubiprostone showed a slower rate of kidney function decline, as measured by changes in estimated glomerular filtration rate (eGFR), a standard gauge of renal performance.
The researchers also investigated the mechanism behind this protective effect. They found that lubiprostone increases the production of spermidine, a compound that promotes mitochondrial activity by fostering the growth of beneficial gut bacteria. This enhancement of mitochondrial function was associated with a renoprotective effect, helping to limit further kidney damage.
Future directions and the promise of personalized CKD care
Looking ahead, the team plans to broaden the investigation with a Phase 3 trial that includes a larger participant pool. They also aim to identify biomarkers that can predict which patients are most likely to benefit from this approach. The ultimate goal is to customize CKD treatment to each individual, marking a notable departure from current therapies that mainly focus on reducing uremic toxins.
Taken together, these results suggest that certain laxatives might slow the progression of kidney deterioration and could pave the way for new strategies to address conditions tied to mitochondrial dysfunction. The study was published in Science Advances.
