Common constipation drug may slow kidney decline in chronic disease patients

A drug normally used for constipation may also help protect kidney function in patients with chronic kidney disease. Lubiprostone, already approved in the US for digestive issues, showed promising results in a recent Japanese trial. Researchers found it could slow the decline of kidney health over 24 weeks in certain patients.

The Phase II trial involved 150 patients across nine medical centres in Japan. Participants received either a placebo or lubiprostone in doses of 8 or 16 micrograms. While the drug did not significantly lower indoxyl sulfate—a gut-derived toxin linked to kidney damage—the higher dose did show benefits.

Patients taking 16 micrograms experienced a slower decline in kidney function compared to those on placebo. Their estimated glomerular filtration rate (eGFR), a key measure of kidney health, remained more stable. The drug also appeared to alter gut microbial pathways, increasing spermidine—a compound that supports mitochondrial activity and may shield kidney tissue. The findings suggest that modifying the gut environment could influence kidney biology in chronic disease. However, the study’s primary goal of reducing indoxyl sulfate was not met. Researchers now call for larger Phase III trials to confirm whether lubiprostone’s effects hold true in a broader population.

Lubiprostone is not yet approved for kidney disease, but the trial offers early evidence of its potential. The 16-microgram dose showed the clearest benefit in preserving kidney function over six months. Further research will determine whether this approach could become a standard treatment for chronic kidney disease.