Feasibility, safety and tolerability of intradialytic creatine supplementation in hemodialysis: A dubbelblind, randomized, placebokontrollerad pilot study.

A small placebokontrollerad pilot examined creatine added to dialysate during haemodialysis. Sixteen patients aged 27 to 78 years completed the study, including nine women. Four sequential groups received 0.5, 1.0, 1.5 or 2.0 mmol/L creatine in dialysate for 6 weeks; within each group, block randomisation allocated creatine or placebo in a 3:1 ratio.

The main outcomes were pre-dialytic creatine concentrations in erythrocytes and plasma. At week 6, the changes in intra-erythrocytic creatine versus placebo were +399, +685, +1146 and +1098 µmol/L across the ascending concentration groups. The 95% confidence interval at 0.5 mmol/L included no increase, while the intervals at the three higher concentrations were positive. One participant at 1.5 mmol/L left because of a possible side effect, but no serious adverse events occurred.

The trial measured whether delivery works, not whether it improves quality of life, muscle function, mortality or any longevity-related outcome. Its conclusion is therefore about feasibility, tolerability and circulating creatine. The abstract itself calls for a larger trial to test clinical effects.

Intradialytic creatine was feasible, safe and well tolerated for increasing circulating creatine in patients receiving haemodialysis.