Studie
Effect of creatine supplementation on kidney function: a systematisk översikt och metaanalys
Pooling 12 studier with 177 creatine och 263 control deltagare, creatine raised serum creatinine by 0.07 (95% CI 0.01 till 0.12, p = 0.03) while glomerular filtration rate showed no significant change.
Elham Kabiri Naeini och colleagues searched PubMed, Scopus, Web of Science och Google Scholar for human studier published från januari 2000 till mars 2025. Twenty-one studier entered the systematisk översikt. Twelve entered the serum-creatinine metaanalys, covering 177 creatine-group och 263 control deltagare. Five studier covering 69 creatine och 74 control deltagare were pooled for glomerular filtration rate. Included designs were RCTs, non-randomised trials, cohorts, case-control och pre-post studier. A slumpmässiga effekter model was used.
Doser across included studier ran från 5 g/day till 20 g/day, with weight-based regimens at 0.03 till 0.3 g/kg/day. Follow-up ranged från 5 days till a mean of 2.9 years i one football-player cohort. Populations included friska sedentary men, football players, postmenopausal kvinnor, army volunteers och adults over 45 with type 2 diabetes.
Serum creatinine rose slightly with creatine: mean difference 0.07, 95% CI 0.01 till 0.12, p = 0.03, I-squared = 69.73%. The increase was significant at follow-up of 1 week or less (MD 0.12, 95% CI 0.03 till 0.21) och not significant between 1 och 12 weeks (MD 0.04, 95% CI -0.09 till 0.17). Glomerular filtration rate showed no significant change (I-squared = 33.17%). The authors describe the creatinine rise as small, modest och transient, och a marker artefact rather than kidney damage.
However, researchers och clinicians should interpret elevated serum creatinine levels i the context of supplementation with caution och consider more specific renal function markers for accurate assessment.
The abstract does not report units for the 0.07 mean difference consistently, och the paper does not give an exact effect estimate, confidence interval or p-value for the GFR outcome, so the reassuring GFR result is stated but not quantified. Heterogeneity for serum creatinine was substantial (I-squared = 69.73%). The pool mixes RCTs with observational och pre-post designs, which carry confounding och selection bias. Most trials were small, single-centre och short; the authors state long-term säkerhet data beyond one year remain sparse. Most trials did not report the creatinine assay type or calibration metod, which may itself explain part of the heterogeneity. Methodological reporting was often missing, including sequence generation, allocation concealment, dropouts och trial registration. Funnel plots showed asymmetry for both outcomes, though trim-och-fill did not change the pooled results. No deltagare with pre-existing kidney disease are represented i a way that supports säkerhet claims for that group. No funding; authors declare no competing interests.
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