HYPE: Creatine damages your kidneys.
But what does the evidence actually show?
Controlled research does not demonstrate kidney damage from usual creatine monohydrate supplementation in healthy adults. Creatinine can rise without a corresponding deterioration in directly measured filtration. That distinction is reassuring, but it does not establish universal safety for people with kidney disease or unlimited use over a lifetime.
Why people believe this
Kidneys remove waste products from the blood. Creatinine is commonly measured to estimate how well they are doing that job. When someone starts a supplement and the result rises, it is reasonable to ask whether the supplement has put their kidneys under strain.
The names also sound almost identical: creatine is involved in energy supply; creatinine is a breakdown product. Supplementation can change the amount of creatinine produced. A test result therefore needs interpretation rather than an automatic conclusion that damage has occurred.
What does the evidence show?
de Souza Almeida et al. (2026)
International Urology and Nephrology
This review included 26 randomised trials and 1,036 participants. Serum creatinine rose, and creatinine-based filtration estimates fell. However, filtration measured using Cr-EDTA did not show a significant reduction; albuminuria, proteinuria and serum urea also showed no significant differences. The authors interpreted the pattern as altered creatinine metabolism rather than demonstrated kidney injury.
Read the research ↗A creatinine-based estimated glomerular filtration rate (eGFR) is calculated rather than directly measured. If the input changes for a reason other than kidney function, the estimate may give a misleading impression. The 2026 review is useful because it separates measurement methods instead of treating them as interchangeable.
Kabiri Naeini et al. (2025)
BMC Nephrology
Across 21 studies, the review found a modest increase in creatinine but no statistically significant difference in GFR in the available pooled data. The studies differed in dose, duration and participants. This supports a qualified safety conclusion, not proof that every possible risk has been excluded.
Read the research ↗A trial that measured filtration directly
Lugaresi et al. (2013)
Journal of the International Society of Sports Nutrition
Healthy resistance-trained adults eating a high-protein diet received creatine or placebo for 12 weeks. The creatine protocol used a short loading phase followed by 5 g/day. Researchers measured filtration with 51Cr-EDTA clearance and found no significant adverse difference. Urinary protein and albumin measures were also reassuring.
Read the research ↗Although its title says “long-term”, this trial lasted three months. Direct measurement makes it valuable, but duration still matters. It cannot establish what happens across decades or in every clinical population.
The strongest evidence
The most informative evidence combines controlled trials, different kidney markers and filtration methods that do not depend only on serum creatinine. An isolated abnormal result or a case report can raise a question; neither alone establishes that creatine caused kidney injury.
The 2017 ISSN position stand also summarised reassuring follow-up in athletes over months and years. Such longer observations add context, but they are not a substitute for large, long-duration randomised studies designed to detect rare harm.
The catch / limitations
Trials often involve selected volunteers, modest sample sizes and shorter follow-up than a lifetime of supplement use. A non-significant result cannot rule out every small effect. Most evidence concerns creatine monohydrate; it should not be transferred automatically to poorly characterised mixtures or every creatine formulation.
Healthy kidneys and existing kidney disease are different questions. The inclusion of some clinical populations in a review does not establish that anyone with chronic kidney disease can safely self-supplement. Reduced kidney function, unexplained abnormal tests or medicines that affect the kidneys warrant individual clinical advice.
What this means for you
If you have blood tests, tell the clinician what supplement and dose you use. A change in creatinine deserves assessment in context; it should neither be assumed to prove damage nor dismissed automatically as a harmless supplement effect. A clinician may consider repeat testing, urine markers, cystatin C or direct filtration assessment when appropriate.
If you already have kidney disease, seek advice before starting. For healthy adults, the current research gives little support to the routine claim that creatine monohydrate damages kidneys. The question of hydration is examined separately in our dehydration investigation.
A creatinine change is not automatically kidney damage. The reassuring evidence applies most clearly to healthy adults using studied creatine monohydrate protocols.
Research & Sources
de Souza Almeida et al. (2026)
Impact of creatine supplementation on kidney health: a systematic review and meta-analysis. International Urology and Nephrology.
Original source ↗
Kabiri Naeini et al. (2025)
Effect of creatine supplementation on kidney function: a systematic review and meta-analysis. BMC Nephrology.
Original source ↗
Lugaresi et al. (2013)
Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet? JISSN.
Original source ↗
Kreider et al. (2017)
ISSN position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.
Original source ↗
Evidence reviewed: October 2026
Evidence vs Hype explains scientific research for educational purposes and does not provide individual medical diagnosis or treatment.