Impact of creatine supplementation on kidney health: a systematic review and meta-analysis
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…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,036 participants or records.
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