Unexpected Hope for Chronic Kidney Disease: Constipation Medication Shows Promise
Chronic kidney disease (CKD) is a global health challenge, often leading to dialysis for survival. Currently, there are no approved medications to restore kidney function. However, a research team led by Professor Takaaki Abe at Tohoku University Graduate School of Medicine has discovered a surprising potential treatment by repurposing a common constipation medication, lubiprostone. This marks the first evidence that lubiprostone can slow the decline of kidney function in individuals with CKD.
The research stemmed from the observation that constipation frequently occurs alongside CKD. Professor Abe explains, “Constipation disrupts the gut microbiome, which negatively impacts kidney function. We hypothesized that improving gut health by treating constipation could, in turn, improve kidney health.”
Lubiprostone Slows Kidney Function Decline in Clinical Trial
A Phase II clinical trial (LUBI-CKD TRIAL) conducted across nine Japanese medical facilities tested this hypothesis. 150 participants with moderate CKD were enrolled and monitored to assess lubiprostone’s effect on kidney health. Those receiving 8 µg or 16 µg of lubiprostone experienced a slower rate of kidney function decline compared to the placebo group,as measured by changes in estimated glomerular filtration rate (eGFR) - a key indicator of kidney performance.
Further investigation revealed how lubiprostone exerts this protective effect. The drug was found to increase the production of spermidine, a compound that boosts mitochondrial activity by fostering the growth of beneficial gut bacteria. This improved mitochondrial function then provided a renoprotective effect, limiting further kidney damage.
Future directions: Personalized CKD Treatment
The team is now planning a larger Phase 3 clinical trial to confirm these findings. They also aim to identify biomarkers that can predict which patients will respond best to lubiprostone.Ultimately,their goal is to develop personalized treatment strategies for CKD,a significant departure from current therapies focused primarily on reducing uremic toxins.
These findings suggest that certain laxatives may offer a new avenue for slowing the progression of kidney disease.This research also opens possibilities for developing treatments for other conditions linked to mitochondrial dysfunction. The study’s details were published in Science Advances.
