The authors report the case of a 24-year-old weight lifter who developed acute kidney failure while taking multiple supplements, including creatine monohydrate. His symptoms were abdominal pain, extreme thirst and a high output of urine, with a large amount of protein in his urine. A kidney biopsy showed “acute interstitial nephritis” (kidney inflammation). He recovered rapidly following discontinuation of the supplements.
The patient had been exercising strenuously 3 hours, 5 times per week and he took 5 gm. creatine, 3 times a week. He also took many other herbal supplements, non-herbal supplements and vitamins, with the total list including fifty two different items.
Creatine is a chemical synthesized in the liver, kidney and pancreas, of which 95% is stored in muscles and used for energy. It is a legal performance enhancing supplement, although recent reports suggest that creatine can cause kidney damage. One young man with kidney failure had been taking 20 gm. daily for 4 weeks. Nephritis is not considered to be dose dependent (that is, even a small dose can cause nephritis.) As many as 48% of young athletes take creatine.
CONCLUSION: The authors conclude that the patient suffered temporary renal damage due to the use of creatine monohydrate and suggest that a warning be included with the product. Creatine induced AIN should be considered in the differential diagnosis of renal failure of young athletes. Large studies are needed of people taking creatine to see what percentage actually develop kidney damage.
NOTE: The authors conclude that the culprit in this case was creatine monohydrate because it was the only one out of a list of fifty two that has been previously associated with renal failure. This is only circumstantial evidence and ignores the possibility that a combination of two or more of the supplements he was taking could have caused the problem. Read about the ergogenic effects of creatine. Read about the importance of creatine as a micronutrient for energy metabolism of the heart. Read about creatine and neuroprotection.
The following address can be used to view a web site with a number of scientific articles about the safety of creatine: