Creatine with Pre-Existing Kidney Issues: A Realistic Guide for CKD, Single Kidney, and Cysts

The standard creatine advice from nearly every major fitness influencer is clear and consistent: "It's one of the safest supplements on the market, and the kidney damage myth has been debunked." This is true—for people with healthy kidneys. The disconnect arises for a significant and anxious audience that this advice completely overlooks: individuals living with Chronic Kidney Disease (CKD), a single kidney, cysts, or other renal conditions. For them, the generalized "it's safe" message is not only unhelpful but potentially dangerous. This audience is left in a high-stakes information vacuum, trying to decide if a performance supplement is worth risking the health of an already compromised organ system.

The core concern is the potential for accelerating irreversible damage. Will taking creatine push Stage 2 CKD to Stage 3? Will it place an unsustainable metabolic load on a single functioning kidney? The fear is that a supplement taken for marginal gains in the gym could lead to a life-altering decline in health, requiring more intensive medical intervention or even dialysis. This is compounded by the confusion over creatinine lab results, which are already a critical marker for monitoring their condition.

For anyone with a pre-existing kidney condition, taking creatine is not a decision to be made based on YouTube videos or online forums. It is a non-negotiable conversation that must be had with a nephrologist (a kidney specialist). Their expert guidance, based on your specific lab results and condition, is the only safe way to proceed.

This topic reveals a critical blind spot for most creators, with only one providing nuanced guidance. The standard approach is to debunk the kidney myth for a general, healthy audience, which fails to serve those who need the information most.

• Dr. Sten Ekberg: Dr. Ekberg is the only creator who directly addresses this issue with specific medical context. He explains that for Chronic Kidney Disease Stages 1-3, limited studies have shown that a 3g/day dose has no adverse effects and might even be beneficial by supplying the kidneys with more energy. However, for CKD Stages 4 and 5, he states that creatine is not recommended. This is not because it's proven harmful, but because there is very little data and the resulting spike in creatinine confuses lab work, making it difficult for doctors to monitor the already severely limited kidney function. This is by far the most valuable and responsible guidance available in the sources.
• Renaissance Periodization (Dr. Mike Israetel): The video's message is that creatine is "fucking amazing" and has no downsides for health. This advice is aimed squarely at healthy individuals. The comment section, however, is filled with questions from people with CKD, Fabry disease affecting their kidneys, and other conditions, demonstrating a clear gap between the content and the audience's needs. One commenter correctly points out the missing nuance: "If you already have kidney issues then creatine is not good. You’re not a Dr., give all sides to a situation".
• ATHLEAN-X (Jeff Cavaliere): Jeff Cavaliere's video focuses on debunking myths like creatine being a steroid or causing hair loss, framing the kidney issue as a misunderstanding over creatinine in healthy people. The content does not provide any guidance for individuals with pre-existing kidney problems, despite viewers asking about it directly in the comments. The comment "Creatine cause kidney damage... if your kidneys are already damaged" highlights the exact point the video misses.
• Jeremy Ethier: His video explicitly states that "creatine has been consistently proven to be a safe supplement for healthy individuals". While accurate, this phrasing intentionally sidesteps the question for those with health conditions, leaving them without an answer. The audience questions in the report reflect this unmet need.
• Jeff Nippard & Myprotein: Both creators' videos completely omit any discussion of creatine use for people with pre-existing kidney disease. Their content focuses on the benefits and general safety, which, while useful for a broad audience, leaves this specific high-risk group to fend for themselves.

• "I was taking creatine for 8 weeks then had to do blood work for unrelated reasons and my kidney function had dropped 40%. Was told to stop taking it and 4 weeks later my function was back to normal."
• "Unfortunately, Creatine isn't for me. It was given me a kind of false reading, showing that I was at top end of CKD Stage 3... It seemed no damage was being done, but it meant that doctor's couldn't get an accurate reading from blood tests, so the risk wasn't damage by creatine use, just that it might have hidden any other negative changes."
• "My doctor always gives me grief about creatine as I've had kidney issues in the past. She sent me to a nephrologist for consult, and he just shook his head and told me to keep taking it. Just like the video said, it messes with the test, not my kidneys."
• "Took creatine and went into kidney failure. Was put on dialysis."
• "My creatinine levels shot up when I started creatine, and Kaiser declared I had Stage 3A kidney disease. When I told my doctor I was taking creatine, he made a note in my file that I was OK."

Find the contact information for your nephrologist or primary care physician. Schedule an appointment specifically to discuss creatine supplementation. Prepare a list of your questions, your current lab values (like your eGFR), and your fitness goals to make the conversation as productive as possible.

• Mistake: Assuming that because some people with kidney issues were cleared by their doctors, you will be too.
  Fix: Recognize that every case is unique. Another person's experience, whether positive or negative, is not a substitute for a personalized medical evaluation of your own health.
• Mistake: Starting creatine and only telling your doctor after your lab results come back looking worse.
  Fix: This causes unnecessary panic and wastes medical resources. Always be proactive and discuss supplement changes before you make them.
• Mistake: Taking a general practitioner's cautionary advice as the final word.
  Fix: While a GP's caution is valid, a nephrologist is the true specialist. As one commenter's story showed, a GP was concerned while the nephrologist understood the nuance and approved continued use. Seek specialist advice.

If you have a pre-existing kidney condition, the general fitness advice about creatine's safety does not apply to you. The overwhelming majority of creators fail to address your specific situation, creating a dangerous information gap. The only creator to provide nuanced guidance was Dr. Sten Ekberg, whose advice can help you frame an intelligent conversation with your specialist. Ultimately, the decision to use creatine must be made in partnership with a nephrologist who understands your unique health profile and can monitor you appropriately. Do not self-experiment.