Chronic kidney disease, often called CKD, is a major health problem that affects hundreds of millions of people worldwide.
The condition develops when the kidneys gradually lose their ability to filter waste products and excess fluid from the blood. Because kidney damage often occurs slowly over many years, many people do not realize they have the disease until it reaches an advanced stage.
Healthy kidneys perform many important jobs. They remove waste products from the body, help control blood pressure, maintain healthy mineral levels, and support the production of red blood cells. When kidney function declines, these processes become less effective, leading to serious health complications.
In severe cases, patients may require dialysis, a treatment that removes waste and extra fluid from the blood using a machine. For some people, a kidney transplant may eventually become necessary. Despite advances in medical care, there are still no approved medications that can directly restore lost kidney function.
Now, researchers from Tohoku University in Japan have discovered a surprising possibility. A medication commonly used to treat constipation may also help protect kidney function and slow the progression of chronic kidney disease.
The study was led by Professor Takaaki Abe and was recently published in the journal Science Advances. According to the researchers, this is the first time a constipation medication has shown potential benefits for protecting the kidneys in patients with CKD.
The drug involved in the study is called lubiprostone. Doctors have prescribed lubiprostone for many years to help people who suffer from chronic constipation. The medication works by increasing fluid secretion in the intestines, making bowel movements easier.
The researchers became interested in lubiprostone after noticing an important pattern among people with chronic kidney disease. Many CKD patients experience constipation, which may seem unrelated to kidney health at first glance.
However, growing evidence suggests that the gut and kidneys are closely connected. Scientists have discovered that changes in gut bacteria can influence many aspects of health, including kidney function. This connection is often called the gut-kidney axis.
When constipation occurs, the normal balance of bacteria in the digestive system can become disrupted. This imbalance, known as dysbiosis, may increase the production of harmful substances that enter the bloodstream and place additional stress on the kidneys.
Professor Abe and his colleagues wondered whether treating constipation could improve gut health and indirectly protect the kidneys.
To investigate this possibility, they conducted a clinical trial involving 150 patients with moderate chronic kidney disease. The study took place across nine hospitals in Japan and was designed to evaluate whether lubiprostone could slow the decline in kidney function.
The researchers monitored kidney health using a standard measurement called estimated glomerular filtration rate, or eGFR. This test estimates how effectively the kidneys filter waste from the blood. Lower eGFR values generally indicate worse kidney function.
The results were encouraging.
Patients who received lubiprostone experienced a slower decline in kidney function compared with what would normally be expected. The protective effect appeared to be stronger among participants who received higher doses of the medication.
The researchers then explored how the drug might be producing these benefits.
Their investigation led them to a substance called spermidine. Spermidine is a naturally occurring compound found in cells and certain foods. It has attracted growing scientific interest because of its potential role in healthy aging and cellular function.
The team discovered that lubiprostone increased levels of spermidine in the body. Higher spermidine levels appeared to promote healthier growth and activity of beneficial gut bacteria.
These changes in the gut microbiome seemed to improve the performance of mitochondria, the tiny structures inside cells that produce energy. Mitochondria are often described as the power plants of the cell because they generate the energy needed for cells to function properly.
When mitochondria become damaged or less efficient, many organs can suffer, including the kidneys. By improving mitochondrial function, lubiprostone may help protect kidney cells from ongoing damage.
This finding is particularly important because mitochondrial dysfunction has been linked to many chronic diseases, including kidney disease, cardiovascular disease, and some age-related conditions.
The study suggests that treating the digestive system may have much broader health effects than previously recognized. Rather than focusing solely on removing toxins from the blood, future CKD treatments may also target gut health, beneficial bacteria, and cellular energy production.
The researchers plan to continue their work with larger clinical studies to confirm the findings. They also hope to identify biological markers that could help predict which patients are most likely to benefit from lubiprostone treatment.
Ultimately, their goal is to develop more personalized approaches to managing chronic kidney disease. By understanding how individual patients respond to treatment, doctors may be able to provide more effective care tailored to each person’s needs.
While additional research is still needed before lubiprostone could become a standard treatment for kidney disease, the results offer new hope for patients living with CKD. The study highlights the growing importance of understanding connections between different organs and body systems.
What began as a treatment for constipation may eventually become part of a new strategy for protecting kidney function and improving the lives of millions of people affected by chronic kidney disease.
If you care about kidney health, please read studies about pesticide linked to chronic kidney disease, and this drug may prevent kidney failure in people with diabetes.
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The study was published in Science Advances.
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