Researchers from Tohoku University Graduate School of Medicine in Japan have discovered that a drug commonly used to treat constipation may slow the progression of kidney damage in people with Chronic Kidney Disease (CKD).
The medication, Lubiprostone, was tested in a multicentre Phase II trial involving 150 patients with moderate CKD treated at nine medical centres. Over a 24-week period those receiving either 8 micrograms or 16 micrograms of the drug saw a slower decline in their estimated glomerular filtration rate (eGFR), the standard measure of kidney performance, compared with those given a placebo.
The research team explored potential mechanisms behind this kidney-protective effect. Their analyses revealed that Lubiprostone appears to modulate the gut microbiome in a way that elevates levels of a polyamine called spermidine. Elevated spermidine in turn supports healthier mitochondrial activity within kidney cells — improved mitochondrial function is believed to reduce cellular stress and damage, which may slow further deterioration of kidney tissue.
The drug did not significantly alter levels of typical waste-byproducts (uremic toxins) that often accumulate in CKD. This suggests that Lubiprostone’s benefit does not rely on reducing those toxins, but rather on influencing a different biological pathway —
the “gut-microbiota → polyamine → mitochondrial function” axis.
Given the promising findings, the researchers plan to move ahead with a larger Phase III trial. The broader aim is to identify biomarkers that could help predict which patients might benefit most from this treatment, potentially paving the way for more personalised kidney-protective therapies.
This development marks a significant shift in how CKD might be managed. To date, no approved medication has been shown to restore or improve kidney function in CKD, treatments have largely focused on slowing harm, managing symptoms, or preparing for dialysis. The idea that a widely used constipation drug could play a role in preserving kidney health would be a big deal, especially for early or moderate-stage CKD patients.
