Creatine supplements and kidney function in people
What it found
Controlled trials in people found no signs that creatine harms the kidneys, though it can raise a blood marker called creatinine.
The authors say this rise does not mean the kidneys are damaged.
What they found
Studies in people
Creatinine marker rises
Creatine supplements can raise blood creatinine in some people. This happens because creatine turns into creatinine on its own, so the rise does not necessarily mean the kidneys are failing.
Controlled trials in people
Many controlled studies in healthy and clinical groups found no signs of kidney harm. Some used accurate methods such as 51 Cr-EDTA clearance to measure kidney filtration.
Case reports limited
Case reports linking creatine to kidney problems often involved pre-existing kidney disease, very high doses, anabolic steroids, other supplements, or extreme exercise. The authors say these reports cannot prove creatine caused the problem.
Pre-existing kidney disease
There is very little evidence on whether creatine is safe for people who already have kidney disease. The authors advise those with very low kidney function to avoid it.
Animal and lab studies
Animal studies mixed
Some rat studies found worse kidney markers, but others did not. Results varied by species and by whether the animals exercised, so the authors say animal findings cannot be simply applied to people.
Other findings
Other creatine forms
Forms other than creatine monohydrate have been much less studied. One, creatine ethyl ester, is less stable and tends to raise blood creatinine more.
What the authors conclude
“Despite some anecdotal reports and experimental data suggesting that creatine could be deleterious to the kidneys, cumulative evidence from independent, randomized controlled trials clearly show this is not the case.”
Also in their conclusions
- They conclude that cumulative evidence from independent, randomized controlled trials clearly shows creatine is not deleterious to the kidneys.
- They advise that people with pre-existing kidney disease causing very low kidney function should avoid creatine supplementation.
- They say consumers should choose creatine supplements that have been properly tested and certified for quality and purity.
How it was done
Creatine is one of the most popular dietary supplements, but concerns remain about whether it could harm kidney health. The authors wanted to review the evidence and give practical advice.
The authors reviewed animal experiments, case reports, and controlled studies in people. The human studies included healthy young and older adults, athletes, and people with conditions such as type 2 diabetes, lupus, Parkinson's disease, and fibromyalgia, with doses from about 5 to 20 grams a day and follow-up up to 24 months.
What it can’t tell you
- Most studies lasted months, not years, so long-term effects beyond about two years are not known.
- There is not enough evidence to show what happens in people who already have kidney disease.
- Case reports can suggest a link but cannot prove that creatine caused a kidney problem.
Who paid
- Conflicts
- B.G. has received research grants, creatine donation for scientific studies, travel support for participation in scientific conferences, and honorarium for speaking at lectures from AlzChem (a company which manufactures creatine). Additionally, he serves as a member of the Scientific Advisory Board for Alzchem.
- Authors work at
- University of Sao Paulo, Brazil; Hospital das Clinicas HCFMUSP, Brazil
The paper
- Title
- Is It Time for a Requiem for Creatine Supplementation-Induced Kidney Failure? A Narrative Review
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Licence
- CC BY. Words in quotation marks are the authors’; the rest is our summary.
- Cite
- Longobardi I, Gualano B, Seguro AC, Roschel H (2023). Is It Time for a Requiem for Creatine Supplementation-Induced Kidney Failure? A Narrative Review. Nutrients. doi:10.3390/nu15061466Free full textPubMed 36986197DOI
Summary written 29 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error