2025-09-01 東北大学
<関連情報>
- https://www.tohoku.ac.jp/japanese/2025/09/press20250901-01-CKD.html
- https://www.tohoku.ac.jp/japanese/newimg/pressimg/tohokuuniv-press20250901_01web_CKD.pdf
- https://www.science.org/doi/10.1126/sciadv.adw3934
慢性腎臓病におけるルビプロストン:無作為化第2相臨床試験から得られたミトコンドリア機能とポリアミンに関する知見 Lubiprostone in chronic kidney disease: Insights into mitochondrial function and polyamines from a randomized phase 2 clinical trial
Shun Watanabe, Masaaki Nakayama, Takashi Yokoo, Satoru Sanada, […] , and LUBI-CKD TRIAL Investigators
Science Advances Published:29 Aug 2025
DOI:https://doi.org/10.1126/sciadv.adw3934
Abstract
Chronic kidney disease (CKD) is a life-threatening condition, and constipation is a progressive risk factor. We evaluated changes in uremic toxins, renal function, and the safety of lubiprostone, a selective chloride channel activator, in patients with CKD. In this phase 2, randomized, double-blind, placebo-controlled trial across nine centers in Japan, 150 patients with stage IIIb–IV CKD received lubiprostone (8 or 16 micrograms) or placebo for 24 weeks. The primary end point was change in indoxyl sulfate levels. Secondary end points included other uremic toxins and renal function markers. Lubiprostone did not alter uremic toxin levels but improved or preserved estimated glomerular filtration rate and its slope in the 16-microgram group. Mild-to-moderate gastrointestinal events occurred in the placebo and 16-microgram groups. Multiomics analysis revealed that lubiprostone modulated the gut microbial agmatine pathway and increased spermidine levels, thereby improving renal mitochondrial function. Lubiprostone is a previously unknown and safe therapeutic option to mitigate renal decline in CKD.
