Renal dysfunction accompanying oral creatine supplements

Poortmans, J.; Francaux, Marc

doi:10.1016/s0140-6736(05)77836-3

Cited by 36 publications

(16 citation statements)

References 4 publications

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“…The safety of oral creatine supplements has been emphasized by Groeneveld and colleagues (43). Although there have been concerns about the potential toxicity of creatine supplements, in partic-ular renal toxicity (44), there is little evidence that this is a clinical problem, provided creatine is highly purified and comes from an approved manufacturer, and there is no preexisting renal disease or serious underlying medical disorders.…”

Section: Discussionmentioning

confidence: 99%

Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six‐month, double‐blind, randomized, placebo‐controlled trial

Chung¹,

Alexanderson²,

Pipitone³

et al. 2007

Arthritis & Rheumatism

115

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Objective. To test the hypothesis that oral creatine supplements with exercise are more effective than exercise alone in improving muscle function in patients with established dermatomyositis or polymyositis receiving chronic medical therapies who are clinically weak yet stable. Methods. In a 6-month, 2-center, double-blind, randomized controlled trial, patients were randomized to receive oral creatine supplements (8 days, 20 gm/day then 3 gm/day) or placebo. All patients followed a home exercise program. The primary outcome was aggregate functional performance time (AFPT), reflecting the ability to undertake high-intensity exercise. Secondary outcomes included a functional index measuring endurance and muscle bioenergetics on 31 P magnetic resonance spectroscopy ( 31 P MRS). Patients were receiving stable immunosuppressive treatment and/or corticosteroids. Results. A total of 37 patients with polymyositis or dermatomyositis were randomized (19 to creatine, 18 to placebo); 29 completed 6 months. Intent-to-treat analyses demonstrated that AFPT improved significantly at 6 months with creatine (median decrease 13%, range -32-8%) compared with placebo (median decrease 3%, range -13-16%; P ‫؍‬ 0.029 by Mann-Whitney U test). A completer analysis also showed significant benefits from creatine (P ‫؍‬ 0.014). The functional index improved significantly with both creatine and placebo (P < 0.05 by paired Wilcoxon's rank sum test), with a significant benefit between groups in the completer analysis only. Phosphocreatine/␤-nucleoside triphosphate ratios using MRS increased significantly in the creatine group (P < 0.05) but not in the control group. No clinically relevant adverse events were associated with creatine. Conclusion. Oral creatine supplements combined with home exercises improve functional performance without significant adverse effects in patients with polymyositis or dermatomyositis. They appear safe, effective, and inexpensive.

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Section: Discussionmentioning

confidence: 99%

Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six‐month, double‐blind, randomized, placebo‐controlled trial

Chung¹,

Alexanderson²,

Pipitone³

et al. 2007

Arthritis & Rheumatism

115

View full text Add to dashboard Cite

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“…A few weeks later, we reported in the same journal that no adverse effects of creatine on kidney function were evident in a group of young healthy adults who supplemented over a period of 9 weeks. 2 This outcome indicated that the observation of Pritchard and Kalra 1 should not be generalized to all creatine consumers. Nonetheless, this particular case shed light on a potential deleterious side effect of creatine supplementation in athletes.…”

mentioning

confidence: 94%

Side Effects of Creatine Supplementation in Athletes

Francaux¹,

Poortmans²

2006

International Journal of Sports Physiology and Performance

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Context:Allegations about side effects of creatine supplementation by athletes have been published in the popular media and scientific publications.Purpose:To examine the experimental evidence relating to the physiological effects of creatine supplementation.Results:One of the purported effects of oral creatine supplementation is increased muscle mass. A review of the literature reveals a 1.0% to 2.3% increase in body mass, which is attributed to fat-free mass and, more specifically, to skeletal-muscle mass. Although it is unlikely that water retention can completely explain these changes, increase in muscle-protein synthesis has never been observed after creatine supplementation. Indirect evidence based on mRNA analyses suggests that transcription of certain genes is enhanced. Although the effect of creatine on muscle-protein synthesis seems irrefutable according to advertising, this allegation remains under debate in the scientific literature. The kidneys appear to maintain their functionality in healthy subjects who supplement with creatine, even over several months.Conclusion:The authors, however, think that creatine supplementation should not be used by an individual with preexisting renal disease and that risk should be evaluated before and during any supplementation period. Even if there is a slight increase in mutagenic agents (methylamine and formaldehyde) in urine after a heavy load of creatine (20 g/day), their excretion remains within a normal range. No data are currently available regarding the potential production of heterocyclic amines with creatine supplementation. In summary, the major risk for health is probably associated with the purity of commercially available creatine.

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“…Within 3 days following the release of this publication a French newspaper L’Equipe reported that creatine supplementation can impair kidney function,9 even though previous studies found creatine supplementation to have no effect on markers of renal stress 16 28 – 30. Despite the apparent safety of creatine the United States media began to report on the dangers of creatine supplementation, focusing on dehydration and muscle cramping.…”

mentioning

confidence: 99%

Putting the Myth of Creatine Supplementation Leading to Muscle Cramps and Dehydration to Rest

et al. 2008

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Creatine is one of the most popular athletic supplements with sales surpassing 400 million dollars in 2004. Due to the popularity and efficacy of creatine supplementation over 200 studies have examined the effects of creatine on athletic performance. Despite the abundance of research suggesting the effectiveness and safety of creatine, a fallacy appears to exist among the general public, driven by media claims and anecdotal reports, that creatine supplementation can result in muscle cramps and dehydration. Although a number of published studies have refuted these claims, a recent position statement by the American College of Sports Medicine (ACSM) in 2000 advised individuals who are managing their weight and exercising intensely or in hot environments to avoid creatine supplementation. Recent reports now suggest that creatine may enhance performance in hot and/or humid conditions by maintaining haematocrit, aiding thermoregulation and reducing exercising heart rate and sweat rate. Creatine may also positively influence plasma volume during the onset of dehydration. Considering these new published findings, little evidence exists that creatine supplementation in the heat presents additional risk, and this should be taken into consideration as position statements and other related documents are published.

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Renal dysfunction accompanying oral creatine supplements

Cited by 36 publications

References 4 publications

Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six‐month, double‐blind, randomized, placebo‐controlled trial

Creatine supplements in patients with idiopathic inflammatory myopathies who are clinically weak after conventional pharmacologic treatment: Six‐month, double‐blind, randomized, placebo‐controlled trial

Side Effects of Creatine Supplementation in Athletes

Putting the Myth of Creatine Supplementation Leading to Muscle Cramps and Dehydration to Rest

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