Does Creatine Damage Your Kidneys? (The Truth)

Summary

• Creatine and creatinine are different but related.

  • Creatine is an energy reserve used especially during short, intense activity, such as sprinting or weightlifting.
  • Most of the body’s creatine is stored in skeletal muscle. Smaller amounts are found in the brain, heart, and testes.
  • Creatine naturally breaks down into creatinine. Blood creatinine is commonly used to assess kidney function, so taking creatine can raise creatinine and make kidney blood tests look concerning even when the kidneys are functioning normally.

• Supplementation can increase the body’s creatine stores.

  • The doctors cite studies in which supplementation raised creatine stores by roughly 20–40%.
  • One comparison found that both a loading schedule of 20 g per day for six days and a lower dose of 3 g per day for 28 days increased total stores by about 20%.
  • They suggest that 3–5 g per day is generally sufficient and question whether taking more than 5 g offers much additional benefit.

• A higher creatinine result does not automatically mean kidney damage.

  • Creatinine can also rise due to factors such as greater muscle mass, strenuous exercise, muscle injury, or dehydration.
  • Estimated GFR (eGFR) relies substantially on creatinine, so it may also be affected by creatine supplementation.
  • Cystatin C is another kidney-function test discussed in the video. The doctors describe it as useful, but not entirely independent of the issue.

• The evidence on kidney safety has limits.

  • The doctors say there is no established mechanism showing how creatine would damage the kidneys. Case reports of kidney problems in people taking creatine do not prove that creatine caused the damage.
  • They describe creatine as having a strong safety record in healthy people and note that studies have not generally shown harm. However, they stress that available research has not definitively proved that creatine cannot damage the kidneys.
  • The video also notes that the Renal Society has recommended that people with polycystic kidney disease avoid creatine, partly because it can complicate the interpretation of blood tests.

• Practical guidance

  • Anyone with kidney disease, concerns about kidney function, or unusual kidney blood-test results should discuss creatine with their doctor or nephrologist before using it.
  • Tell your clinician if you are taking creatine so test results can be interpreted in context.
  • Drink according to thirst; the doctors say there is no need to obsess over extra water or aim for perfectly clear urine. Creatine can increase the amount of water stored in muscles and may contribute to initial weight gain.

• The doctors differ on whether they would use creatine with poor kidney function.

  • One would consider it, given the lack of strong evidence of harm, but would monitor blood tests closely.
  • The other would avoid it because kidney safety is not definitively established and creatinine is routinely used to monitor kidney function.

Speakers and Sources Featured

• Dr. Brad Weening — co-host; his surname is rendered as “Weining” in the auto-generated subtitles.
• Dr. Paul Zalzal — co-host; his surname is garbled in the subtitles as “Salad.”
• Sources discussed: Research studies on creatine supplementation and kidney testing, and the Renal Society’s recommendation regarding polycystic kidney disease. Dr. Pande/Pandeya is mentioned in reference to an earlier discussion but does not speak in these subtitles.