Is creatine safe for your kidneys?

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Creatinine is a byproduct of the breakdown of creatine and phosphocreatine in the body. It is also a commonly used marker of kidney function.

Because supplementing with creatine can increase the blood levels of creatinine, there have been some concerns about a potential negative effect of creatine on kidney function. However, beyond a harmless increase in creatinine levels, scientific reviews on both the long- and short-term safety of supplemental creatine in people with healthy kidneys have consistently found no adverse effects on kidney function with a wide range of doses.[1][2][3][4][5][6][7][8] That said, although doses of >10 g/day have been found not to impair kidney function, fewer long-term trials have assessed the safety of such high chronic daily intakes.

Similar findings have been reported in trials looking at the effect of supplemental creatine in people with kidney disease, with trials reporting no detrimental effects on kidney function.[9][10][11] That said, long-term trials assessing the safety of supplemental creatine in people with kidney disease are lacking. Also, it’s worth keeping in mind that, because creatine can increase water retention, it could theoretically adversely affect individuals whose kidney disorder is being treated with diuretics, which cause water loss.

Overall, the available evidence suggests that short- and long-term supplementation with creatine is likely safe for people with healthy kidneys, and that short-term supplementation with creatine is likely safe for people with suboptimal kidney function. Less is known about the effects of long-term supplementation with creatine in people with suboptimal kidney function.

Also, it’s worth keeping in mind that, although elevated creatinine levels in response to supplementation with creatine are not indicative of kidney damage, creatine’s ability to raise creatinine levels could potentially mask underlying health issues.

1.^Poortmans JR, Francaux MAdverse effects of creatine supplementation: fact or fiction?Sports Med.(2000 Sep)
2.^Farquhar WB, Zambraski EJEffects of creatine use on the athlete's kidneyCurr Sports Med Rep.(2002 Apr)
3.^Pline KA, Smith CLThe effect of creatine intake on renal functionAnn Pharmacother.(2005 Jun)
4.^Francaux M, Poortmans JRSide effects of creatine supplementation in athletesInt J Sports Physiol Perform.(2006 Dec)
5.^Persky AM, Rawson ESSafety of creatine supplementationSubcell Biochem.(2007)
6.^Kim HJ, Kim CK, Carpentier A, Poortmans JRStudies on the safety of creatine supplementationAmino Acids.(2011 May)
7.^Gualano B, Roschel H, Lancha AH Jr, Brightbill CE, Rawson ESIn sickness and in health: the widespread application of creatine supplementationAmino Acids.(2012 Aug)
8.^Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HLInternational Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicineJ Int Soc Sports Nutr.(2017 Jun 13)
9.^Gualano B, de Salles Painelli V, Roschel H, Lugaresi R, Dorea E, Artioli GG, Lima FR, da Silva ME, Cunha MR, Seguro AC, Shimizu MH, Otaduy MC, Sapienza MT, da Costa Leite C, Bonfá E, Lancha Junior AHCreatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trialEur J Appl Physiol.(2011 May)
10.^Taes YE, Delanghe JR, De Bacquer D, Langlois M, Stevens L, Geerolf I, Lameire NH, De Vriese ASCreatine supplementation does not decrease total plasma homocysteine in chronic hemodialysis patientsKidney Int.(2004 Dec)
11.^Shelmadine BD, Hudson GM, Buford TW et al.The effects of supplementation of creatine on total homocysteineJ Ren Nurs..(2012 Sep)