Lubiprostone and Renal Function in Chronic Kidney Disease
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on October 1st, 2025
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Lubiprostone, a chloride channel activator commonly used to treat constipation, has been linked in previous large-scale observational studies to a lower risk of renal complications in patients with chronic kidney disease (CKD). To investigate this potential renoprotective effect further, the Japan Agency for Medical Research and Development funded a study examining lubiprostone in CKD patients.
The phase 2 clinical trial conducted in Japan enrolled 116 participants with an average age of 63 years and a mean estimated glomerular filtration rate (eGFR) of 35 mL/min/1.73 m². Over 80% of the participants had hypertension, and around 60% had dyslipidemia. Patients were randomly assigned to receive either placebo or lubiprostone at a daily dose of 8 or 16 micrograms.
After 24 weeks, lubiprostone did not significantly reduce uremic toxin levels. However, patients receiving lubiprostone showed minor improvements or stabilization of eGFR compared with the placebo group. The renoprotective effects of lubiprostone appear to be independent of uremic toxin reduction and may be mediated by increased polyamine production from the gut microbiome, enhancing renal mitochondrial function. The authors recommend that future studies include larger sample sizes and a higher proportion of female participants.
The phase 2 clinical trial conducted in Japan enrolled 116 participants with an average age of 63 years and a mean estimated glomerular filtration rate (eGFR) of 35 mL/min/1.73 m². Over 80% of the participants had hypertension, and around 60% had dyslipidemia. Patients were randomly assigned to receive either placebo or lubiprostone at a daily dose of 8 or 16 micrograms.
After 24 weeks, lubiprostone did not significantly reduce uremic toxin levels. However, patients receiving lubiprostone showed minor improvements or stabilization of eGFR compared with the placebo group. The renoprotective effects of lubiprostone appear to be independent of uremic toxin reduction and may be mediated by increased polyamine production from the gut microbiome, enhancing renal mitochondrial function. The authors recommend that future studies include larger sample sizes and a higher proportion of female participants.