At a Glance
- A Japanese clinical trial found the constipation drug lubiprostone can slow the decline of renal function in patients with moderate chronic kidney disease, offering a new treatment avenue.
- The study demonstrated that a 16-microgram dose of lubiprostone improved or preserved the estimated glomerular filtration rate, a key indicator of kidney health, over 24 weeks.
- Researchers have discovered that the drug works by altering the gut microbiota, which increases spermidine levels and subsequently enhances mitochondrial function within the kidneys, thereby protecting them from further damage.
- The trial confirmed the drug’s safety, with only mild to moderate gastrointestinal side effects reported, which were comparable to those in the placebo group.
- This finding shifts the focus of chronic kidney disease therapy from reducing uremic toxins to a new strategy of using laxatives to improve gut-kidney communication.
Researchers in Japan have made a breakthrough discovery, finding that a common medication for constipation may significantly slow the progression of chronic kidney disease, or CKD. A team led by Professor Takaaki Abe at Tohoku University Graduate School of Medicine found that the drug lubiprostone can preserve kidney function, offering the first potential therapeutic to do so. This finding, published in Science Advances, pioneers a new treatment strategy for a condition that affects millions worldwide and often leads to life-threatening kidney failure.
The discovery stemmed from the observation that constipation frequently accompanies CKD. “Constipation disrupts the intestinal microbiota, which worsens kidney function,” explained Abe in a university press release. “Working backwards, we hypothesized that we could improve kidney function by treating constipation.” To test this, the team conducted a 24-week, double-masked clinical trial involving 150 patients with moderate to severe CKD across nine medical centers. Patients received either a placebo or one of two doses of lubiprostone. The results showed that patients taking the higher dose of the drug had a preserved estimated glomerular filtration rate, a key measure of how well the kidneys are filtering waste from the blood.
A multiomics analysis, which examines multiple sets of biological data, revealed how the drug achieves this protective effect. Lubiprostone appears to alter the gut microbiome—the community of bacteria living in the intestines—in a way that boosts the production of a compound called spermidine. Higher spermidine levels were found to improve the function of mitochondria, the powerhouses within the kidney’s cells. By enhancing cellular energy production, the drug helps protect the kidneys from further damage, representing an entirely new approach compared to traditional treatments that focus on reducing toxins in the blood.
With this promising Phase II trial complete, the research team is planning a larger Phase III trial to validate the results in the broader population. This groundbreaking work suggests that targeting gut health with a safe, existing medication could transform the standard of care for CKD. This new strategy focusing on the “gut-kidney axis” may also open doors for developing treatments for other diseases linked to mitochondrial dysfunction.
References
- Tohoku University. (2025, August 29). Clinical trial shows constipation drug can treat patients with chronic kidney disease. Medical Xpress; Tohoku University. https://medicalxpress.com/news/2025-08-clinical-trial-constipation-drug-patients.html
- Watanabe, S., Nakayama, M., Yokoo, T., Sanada, S., Ubara, Y., Komatsuda, A., Asanuma, K., Suzuki, Y., Konta, T., Kazama, J. J., Suzuki, T., Fukuda, S., Soga, T., Yamada, T., Mizutani, S., Matsumoto, M., Naito, Y., Taguchi, K., Fukami, K., … LUBI-CKD TRIAL Investigators. (2025). Lubiprostone in chronic kidney disease: Insights into mitochondrial function and polyamines from a randomized phase 2 clinical trial. Science Advances, 11(35), eadw3934. https://doi.org/10.1126/sciadv.adw3934
