From the Research
Creatine supplementation is not recommended for patients with Chronic Kidney Disease (CKD) unless specifically advised by a nephrologist, due to potential risks of exacerbating kidney damage and complicating kidney function monitoring. The primary concern is that creatine metabolism produces creatinine as a byproduct, which is normally filtered by the kidneys, and in CKD patients, elevated creatinine levels can further stress the already impaired kidneys and potentially accelerate disease progression 1. Additionally, creatine supplementation may lead to false elevations in serum creatinine, complicating the monitoring of kidney function in these patients.
Some studies suggest that CKD patients may be depleted of creatine, particularly those on dialysis, and that creatine supplementation may be beneficial in improving muscle status, nutritional status, and quality of life 2, 3. However, these findings are based on hypothetical and narrative reviews, and more recent and higher-quality studies are needed to support these claims. A more recent study found that L-Carnitine or creatine supplementation may provide an effective adjuvant or therapeutic regimen that significantly reduces oxidative and inflammatory stress and erythropoietin-resistant anemia, but no significant changes were found in biochemical alteration such as creatinine, uric acid, urea, etc., after creatine supplementation in a patient with renal dysfunction 4.
In general, CKD patients should focus on maintaining a balanced diet rich in high-quality proteins, as recommended by their dietitian, and engage in appropriate exercise as advised by their healthcare team. These measures can help support muscle health and overall well-being without the potential risks associated with creatine supplementation in the context of kidney disease. If a CKD patient is considering creatine supplementation for specific reasons, such as severe muscle wasting, it should only be done under close medical supervision, with regular monitoring of kidney function, including creatinine levels and estimated glomerular filtration rate (eGFR) 5.
Key considerations for CKD patients include:
- Avoiding creatine supplements unless specifically advised by a nephrologist
- Maintaining a balanced diet rich in high-quality proteins
- Engaging in appropriate exercise as advised by their healthcare team
- Regular monitoring of kidney function, including creatinine levels and estimated glomerular filtration rate (eGFR), if creatine supplementation is considered.