A common constipation drug shows surprising power to protect kidneys

Common constipation drug lubiprostone shows promise in slowing chronic kidney disease by altering gut bacteria to boost protective spermidine levels. | Contesto: cronaca

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• A common constipation drug shows surprising power to protect kidneys

Contesto

A widely used constipation medication may offer an unexpected new weapon against chronic kidney disease, a condition that affects hundreds of millions worldwide and often progresses to dialysis or transplant. In a clinical trial involving 150 patients with moderate chronic kidney disease, researchers found that lubiprostone, a drug typically prescribed for constipation, helped preserve kidney function over the study period. The findings, published in a peer-reviewed journal, point to a novel mechanism: the drug appears to alter the composition of gut bacteria, leading to increased production of spermidine, a naturally occurring compound known to support mitochondrial health and reduce cellular damage in the kidneys. Scientists said the results open a potential new avenue for treating a disease that has seen few therapeutic breakthroughs in recent decades. Chronic kidney disease, or CKD, is a progressive loss of kidney function that affects an estimated one in seven adults globally. It is often driven by diabetes, high blood pressure, or glomerulonephritis, and many patients eventually require dialysis or a kidney transplant. Current treatments focus on managing blood pressure, controlling blood sugar, and using medications like ACE inhibitors, but none directly target the underlying cellular decline that characterizes the disease. The trial enrolled patients with stage 3 to 4 CKD, meaning moderate to severe reduction in kidney function. Over the course of the study, those who received lubiprostone showed a slower decline in estimated glomerular filtration rate, a key measure of kidney performance, compared to a placebo group. The effect was most pronounced in patients with higher levels of inflammation at baseline. Researchers traced the benefit to changes in the gut microbiome. Lubiprostone, originally developed to increase fluid secretion in the intestines, appears to shift the balance of bacterial species in the gut, promoting those that produce spermidine. Spermidine is a polyamine that has been shown in animal studies to enhance autophagy, the cellular cleanup process, and improve mitochondrial function, both of which are impaired in CKD. The study is...

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Categoria: cronaca