A team of scientists led by Professor Takaaki Abe at the Tohoku University Graduate School of Medicine has found that a medication typically used to treat constipation may offer new hope for people living with chronic kidney disease (CKD).
This is the first time researchers have demonstrated that lubiprostone, a commonly prescribed constipation drug, can actually slow kidney function decline in those with CKD. As CKD remains a significant health concern worldwide—often progressing to kidney failure requiring dialysis—there is a critical need for treatments that target kidney function directly. Presently, no such medications exist.
To investigate, Abe’s team launched a multicenter Phase II clinical study, named the LUBI-CKD Trial, which involved nine hospitals across Japan. A total of 150 participants with moderate CKD took part, with the goal of evaluating lubiprostone’s impact on their kidney health.
The results were promising: patients who received either 8 µg or 16 µg of lubiprostone demonstrated a slower decline in kidney function—as measured by estimated glomerular filtration rate (eGFR)—than those who received a placebo. The effect was dose-dependent, meaning higher doses offered more protection.
Further investigation revealed that lubiprostone works by increasing the production of spermidine, a compound known to enhance mitochondrial function. It does so by encouraging the growth of beneficial gut bacteria. Robust mitochondrial activity was shown to help protect kidney cells from further damage.
Professor Abe emphasized, “Since constipation is a frequent problem among people with CKD, and often disrupts gut bacteria, it can worsen kidney health. We wondered whether addressing constipation might improve kidney outcomes, and our study supports this hypothesis.”
Moving forward, the research team plans to perform a larger Phase III trial to confirm these findings, and to identify biomarkers that can predict which patients might benefit most from this treatment.
The full study appears in Science Advances, and experts believe these results could transform CKD treatment approaches—from merely managing toxin buildup to actively using targeted laxatives to slow the disease’s progression. Additionally, the insights may lead to new therapies for other disorders related to mitochondrial dysfunction.
