From the Guidelines
Individuals with kidney disease should avoid creatine supplementation unless specifically approved by their healthcare provider, as it may place additional stress on already compromised kidneys and complicate the monitoring of kidney disease progression. Creatine, a popular supplement for muscle building and athletic performance, is not recommended for those with kidney problems due to potential risks. While creatine is generally safe for healthy individuals, it can increase creatinine levels in the blood, which is used as a marker for kidney function, as noted in a study published in the American Journal of Kidney Diseases 1.
For those with existing kidney disease, creatine may lead to a misclassification of acute kidney injury due to its influence on creatinine clearance measurements, as observed in a unique situation of using creatine supplementation in a patient with a solitary kidney 1. The kidneys play a crucial role in filtering and excreting creatinine, a byproduct of creatine metabolism. In individuals with reduced kidney function, this process may be impaired, potentially leading to further kidney damage or accelerated disease progression.
Some studies have investigated the use of creatine in patients with various conditions, including Duchenne muscular dystrophy, but no clear benefits were found, and caution is advised when using creatine in patients with renal dysfunction 1. Healthy individuals without kidney issues can typically use creatine safely, with a standard dosage of 3-5 grams per day, taken orally. However, anyone considering creatine supplementation should consult with a healthcare provider first, especially if they have a family history of kidney disease or other risk factors. Regular kidney function tests may be advisable for long-term creatine users, even in the absence of kidney disease, to monitor any potential changes in kidney function over time.
Key considerations for patients with kidney disease include:
- Avoiding creatine supplementation unless approved by a healthcare provider
- Monitoring kidney function regularly if using creatine
- Being aware of the potential risks of creatine supplementation on kidney function
- Consulting with a healthcare provider before starting creatine supplementation, especially if there are pre-existing kidney conditions or risk factors.
From the Research
Relationship Between Creatine Supplementation and Kidney Function
- The current evidence suggests that creatine supplementation does not have a significant impact on kidney function in healthy individuals 2, 3, 4, 5, 6.
- However, it is recommended that individuals with pre-existing kidney disease or those at risk of kidney dysfunction should avoid using creatine supplements 2, 3, 6.
- Some studies have reported that creatine supplementation may increase serum creatinine levels, which can lead to an overestimation of kidney disease severity 3, 4, 5.
- High-dose creatine supplementation (>3-5 g/day) should be avoided in individuals with pre-existing renal disease or those with a potential risk for renal dysfunction 6.
- The available evidence is based on studies with controlled designs, and most of them have found no significant adverse effects of creatine supplementation on kidney function 2, 3, 4, 5, 6.
Key Findings
- A review of 19 clinical and experimental articles found no significant effects of creatine supplementation on kidney function in healthy athletes and bodybuilders 2.
- A narrative review of the effects of creatine supplementation on kidney function found that clinical trials do not support the claim that creatine impairs kidney function 4.
- A case study of a young man with a single kidney found that short-term creatine supplementation did not affect kidney function 5.
- A review of the safety of creatine supplementation found that liver and kidney function are not affected in healthy subjects supplemented with creatine, even during several months 6.