Creatine and Kidney Disease or Reduced Kidney Function: Who Should Ask a Clinician First
What small trials, case reports and reviews say about creatine in kidney disease, dialysis and kidney transplant, and why a kidney doctor should be asked first.
Content last updated . This page has not been medically reviewed.
Urgent first: ask your kidney doctor, and never stop a medicine alone
If you have kidney disease at any stage, are on dialysis, have a kidney transplant, or have been told your kidney filtering is reduced, ask your kidney doctor or pharmacist before using creatine. The National Kidney Foundation (US) lists creatine among supplements with a high level of risk for people with kidney disease, especially kidney failure. [1] The same page warns that herbal supplements can interact with prescription medicines and that, after a transplant, this can raise the risk of losing the new kidney. [1]Do not stop or change a prescribed medicine because of this page. Early kidney disease usually has no symptoms, so a person can have it without knowing. [2]
What "reduced kidney function" means
NIDDK describes a GFR (a measure of kidney filtering) of 60 or more as in the normal range, and below 60 as possibly meaning kidney disease. [2] Creatine can also raise the creatinine that this estimate is built from, which is why results need careful reading (see Creatinine, eGFR and Cystatin C).What the research covers
Evidence labels: "promising but limited" means small or short studies; "insufficient evidence" means too little to judge safety. A change in a lab marker is not a health outcome.| Group | What the source found | Evidence label |
|---|---|---|
| Pooled analysis including kidney disease | A 2026 meta-analysis of 26 trials included people with chronic kidney disease. Its authors judged the creatinine rise likely reflects metabolism, not injury. [3] | Promising but limited |
| Type 2 diabetes | In a 12-week trial with exercise training, measured clearance did not differ between creatine and placebo. [4] Average clearance at the start was about 90 mL/min/1.73 m2 in the creatine group, above the 60 mark, so it says little about people with clearly reduced function. [4] | Promising but limited |
| Older adults with Parkinson disease | In a 2-year trial, cystatin C stayed normal, and the main side effects were stomach complaints. [5] The trial was in Parkinson disease, not kidney disease. | Promising but limited |
| Hemodialysis | Small trials, for example a pilot with 15 patients per group aged 18 to 59 for four weeks, reported lower malnutrition-inflammation scores. [6] A one-year trial using 5 g a day found more fat-free mass but no change in that score. [7] A 2026 pilot of creatine added to dialysis fluid reported it was well tolerated with no serious adverse events. [8] A crossover trial found creatine changed levels of several guanidino compounds (waste-type chemicals); the abstract does not say what this means for health. [9] | Insufficient evidence |
| Kidney transplant | One case report and one observational study (below). | Insufficient evidence |
The dialysis trials measured body composition and nutrition scores, not kidney disease progression or survival. Amounts above are study amounts, not advice.
Kidney transplant
A case report described a transplant recipient whose serum creatinine rose while taking a creatine ethyl ester product. A biopsy and an ultrasound were normal, and creatinine settled after stopping. The authors said creatinine was not a valid stand-in for filtering in that case. [10] This is one report about one form, so it should not be applied to other forms.An observational study of 553 transplant recipients found a total creatine pool 14% lower than in healthy controls; the authors suggested supplements might help people with low kidney function. [11] That is a hypothesis, not a safety finding.
Proper evidence not found: randomized trials of creatine supplements in kidney transplant recipients. We searched PubMed for creatine with kidney transplant and found only the case report, the observational study and a review. [12]
Why the tests matter more here
MedlinePlus says a measured GFR is sometimes used when a health condition makes an eGFR unreliable. [13] Your clinician may therefore want to know about creatine before choosing which test to follow.Questions to take to your appointment
- Is my kidney function stable enough that this has been checked recently?
- Which test should track it: creatinine, cystatin C or a measured GFR?
- Do my other medicines, or pain relievers and water pills, affect my kidneys?
See also Questions to ask your clinician or pharmacist, Creatine and medicines, Minerals, supplements and kidney disease and Existing conditions.
Frequently asked questions
Can people with kidney disease use creatine?
Ask your kidney doctor first. A 2026 review says concerns persist about creatine in impaired kidney function, and the National Kidney Foundation lists it among high-risk supplements. [12] [1]
Is creatine safe on dialysis?
Small trials reported good tolerance, but they were short and measured nutrition outcomes. [8] [7] Only the dialysis team can judge it for you.
Can creatine treat kidney disease?
We found no source showing that. Researchers are studying muscle loss in kidney disease because hemodialysis is linked to loss of fat-free mass, but the trials we read measured body composition and nutrition scores. [7]
I have a kidney transplant. Is creatine an option?
Talk to your transplant team. We found only one case report and one observational study, and no randomized trials. [10] [11]
Does a high creatinine on creatine mean my kidneys are worse?
Not by itself. Creatine can raise creatinine without a change in measured filtering, and a clinician may use other tests. [3] [14]
References
- National Kidney Foundation (US). Herbal Supplements and Kidney Disease. Read 2026-10-23.
- National Institute of Diabetes and Digestive and Kidney Diseases (US). Chronic Kidney Disease Tests & Diagnosis. Read 2026-10-23.
- de Souza Almeida A, da Silva LOD, Takahasi BNA, et al. Impact of creatine supplementation on kidney health: a systematic review and meta-analysis. Int Urol Nephrol 2026 (abstract read; authors declare no competing interests). Read 2026-10-23.
- Gualano B, de Salles Painelli V, Roschel H, et al. Creatine supplementation does not impair kidney function in type 2 diabetic patients: a randomized, double-blind, placebo-controlled, clinical trial. Eur J Appl Physiol 2011 (abstract read). Read 2026-10-23.
- Bender A, Samtleben W, Elstner M, Klopstock T. Long-term creatine supplementation is safe in aged patients with Parkinson disease. Nutr Res 2008 (abstract read). Read 2026-10-23.
- Marini ACB, Motobu RD, Freitas ATV, et al. Short-term creatine supplementation may alleviate the malnutrition-inflammation score and lean body mass loss in hemodialysis patients: a pilot randomized placebo-controlled trial. JPEN J Parenter Enteral Nutr 2020 (abstract read). Read 2026-10-23.
- Marini ACB, Schincaglia RM, Candow DG, Pimentel GD. Effect of creatine supplementation on body composition and malnutrition-inflammation score in hemodialysis patients: an exploratory 1-year, balanced, double-blind design. Nutrients 2024 (abstract read). Read 2026-10-23.
- Doorenbos CSE, van der Veen Y, Post A, et al. Feasibility, safety and tolerability of intradialytic creatine supplementation in hemodialysis: a double-blind, randomized, placebo-controlled pilot study. PLoS One 2026 (abstract read). Read 2026-10-23.
- Taes YE, Marescau B, De Vriese A, et al. Guanidino compounds after creatine supplementation in renal failure patients and their relation to inflammatory status. Nephrol Dial Transplant 2008 (abstract read). Read 2026-10-23.
- Law JP, Di Gerlando S, Pankhurst T, Kamesh L. Elevation of serum creatinine in a renal transplant patient following oral creatine supplementation. Clin Kidney J 2018 (case report, abstract read). Read 2026-10-23.
- Post A, Groothof D, Kremer D, et al. Creatine homeostasis and the kidney: comparison between kidney transplant recipients and healthy controls. Amino Acids 2024 (observational study, abstract read). Read 2026-10-23.
- Pereira JP, Leal VO, Trigueira P, et al. Creatine supplementation in patients with kidney disease - harm or benefit? Nephrol Dial Transplant 2026 (narrative review, abstract read). Read 2026-10-23.
- MedlinePlus (US National Library of Medicine). Estimated Glomerular Filtration Rate (eGFR) and GFR Tests. Read 2026-10-23.
- MedlinePlus (US National Library of Medicine). Creatinine Test. Read 2026-10-23.