Laboratory of Nutrition and Metabolism Applied to Exercise, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Am J Kidney Dis. 2010 Mar;55(3):e7-9. doi: 10.1053/j.ajkd.2009.10.053. Epub 2010 Jan 8.
It currently is unknown whether creatine supplementation is safe for people with or at risk of kidney disease. We report on the short-term effects of creatine supplementation on kidney function in a young man with a single kidney and mildly decreased glomerular filtration rate (GFR). A 20-year-old man who had undergone unilateral nephrectomy and presented with mildly decreased GFR without kidney damage underwent a trial with 35 days of creatine supplementation (20 g/d for 5 days followed by 5 g/d for the next 30 days) and had his kidney function monitored. After the intervention, (51)Cr-EDTA clearance (pre, 81.6 mL/min/1.73 m(2); post, 82.0 mL/min/1.73 m(2)), proteinuria (protein excretion: pre, 130 mg/d; post, 120 mg/d), and electrolyte levels were unchanged. Albuminuria, serum urea level, and estimated creatinine clearance were decreased (pre, 4.6 mg/d; post, 2.9 mg/d; pre, 37 mg/d; post, 28 mg/dL; and pre, 88 mL/min/1.73 m(2); post, 71 mL/min/1.73 m(2), respectively), whereas serum creatinine level was slightly increased (pre, 1.03 mg/dL; post, 1.27 mg/dL), falsely suggesting kidney function impairment. This prospective report suggests that short-term creatine supplementation may not affect kidney function in an individual with a single kidney, mild decreased GFR, and ingesting a high-protein diet (ie, 2.8 g/kg/d). This finding has great relevance considering that creatine-induced kidney disease has been a growing concern, even for healthy people.
目前尚不清楚肌酸补充剂是否对患有或有肾脏疾病风险的人安全。我们报告了一例短期肌酸补充对单侧肾脏和肾小球滤过率(GFR)轻度降低的年轻患者肾功能的影响。一名 20 岁男性曾接受过单侧肾切除术,表现为 GFR 轻度降低而无肾损伤,他接受了为期 35 天的肌酸补充试验(前 5 天每天 20 g,后 30 天每天 5 g),并监测其肾功能。干预后,(51)Cr-EDTA 清除率(治疗前,81.6 mL/min/1.73 m2;治疗后,82.0 mL/min/1.73 m2)、蛋白尿(尿蛋白排泄:治疗前,130 mg/d;治疗后,120 mg/d)和电解质水平均无变化。白蛋白尿、血清尿素水平和估计的肌酐清除率降低(治疗前,4.6 mg/d;治疗后,2.9 mg/d;治疗前,37 mg/d;治疗后,28 mg/dL;治疗前,88 mL/min/1.73 m2;治疗后,71 mL/min/1.73 m2),而血清肌酐水平略有升高(治疗前,1.03 mg/dL;治疗后,1.27 mg/dL),这表明肾功能受损。这项前瞻性报告表明,短期肌酸补充可能不会影响单侧肾脏、GFR 轻度降低且摄入高蛋白饮食(即 2.8 g/kg/d)的个体的肾功能。考虑到肌酸引起的肾病甚至对健康人来说都是一个日益严重的问题,这一发现具有重要意义。