Common Constipation Drug May Slow Kidney Decline in Chronic Disease Patients

A drug normally used for constipation could offer a new way to slow kidney decline in chronic disease patients. Lubiprostone, already approved in the US for bowel issues, has shown promise in protecting kidney function during a recent trial. Researchers now suggest it may help preserve kidney health by altering gut bacteria and improving cell energy processes. The Phase II trial involved 150 patients with moderate chronic kidney disease across nine Japanese medical centres. Participants received either a placebo or one of two lubiprostone doses (8 or 16 micrograms) for 24 weeks. While the drug did not significantly reduce indoxyl sulfate—a toxin linked to kidney damage—it did show benefits in kidney function.

Patients taking the higher 16-microgram dose experienced better preservation of their estimated glomerular filtration rate (eGFR) compared to the placebo group. The study also found that lubiprostone altered gut microbial pathways, increasing levels of spermidine, a compound tied to mitochondrial activity. Researchers believe this shift may help protect kidney tissue by improving how cells produce energy. Despite these positive findings, the drug’s primary goal—lowering indoxyl sulfate—was not met. The team has called for larger Phase III trials to confirm whether lubiprostone can reliably slow kidney decline in a wider patient group.

The results suggest lubiprostone could become a new option for managing chronic kidney disease, though further testing is required. If confirmed, its ability to preserve eGFR and influence gut-kidney interactions may offer a fresh approach to treatment. For now, the drug remains approved only for constipation, not kidney-related conditions.