Impact of creatine supplementation on kidney health: a systematic review and meta-analysis
In brief
Creatine supplements raise serum creatinine and cut creatinine-based GFR
A meta-analysis of 26 randomized trials (1036 participants) found that creatine intake increased serum creatinine by about 0.14 mg/dL and lowered creatinine-based estimated GFR by roughly 11 mL/min in both healthy adults and those with chronic kidney disease. Alternative GFR measurement with Cr-EDTA showed no change, suggesting the rise reflects altered creatinine metabolism rather than true kidney injury.
- Journal
- International urology and nephrology (Q2)
- Published
- 27 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Artur de Souza Almeida, Leonardo Olimpio Dias da Silva, Bianca Namie Abe Takahasi, Bruno Damico Terada, Felipe Giraldo Alvarez Gonçalves, Breno Cordeiro Porto, et al.
- PMID
- 42507286
- DOI
- 10.1007/s11255-026-05287-x
Why clinicians should know about it
- Picked for Nephrology (paper of the day, 28 July 2026).
Abstract
PURPOSE: To evaluate the safety of creatine supplementation on kidney health in healthy individuals and patients with CKD. METHODS: The MEDLINE, Embase, Cochrane Library, and Google Scholar databases were systematically searched for RCTs from inception to March 2025. Studies comparing creatine supplementation with placebo in human subjects that assessed kidney health parameters were selected by 2 independent reviewers following PRISMA guidelines. A random-effects model was used to pool mean differences with 95% CI. The primary outcome was serum creatinine level. Secondary outcomes included GFR assessed by creatinine-based methods and by Cr-EDTA, serum urea, albuminuria, proteinuria, and urinary creatinine. RESULTS: Twenty-six studies (1036 participants) were included. Creatine supplementation was associated with a significant increase in serum creatinine levels (MD, 0.14 mg/dL; 95% CI 0.05-0.22; P = .002; I2 = 93.9%) and a reduction in GFR assessed by creatinine-based methods (MD, -10.75 mL/min; 95% CI -17.48 to -4.02; P = .002; I2 = 0%). No significant differences were observed when assessed by Cr-EDTA (MD, 5.89 mL/min; 95% CI -0.30 to 12.08; P = .06; I2 = 6.3%) or in serum urea, albuminuria, proteinuria, and urinary creatinine. In the hemodialysis subgroup, creatine supplementation was associated with a significant increase in serum creatinine; conversely, serum urea levels were significantly reduced. CONCLUSIONS: Creatine supplementation is associated with increased serum creatinine levels and reduced glomerular filtration rate estimated by creatinine-based methods in healthy individuals and patients with chronic kidney disease. These findings likely reflect altered creatinine metabolism rather than kidney injury, given the absence of changes when assessed using Cr-EDTA. TRAIL REGISTRY: CRD420251015042.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.