Introduction

The question “can creatine cause kidney stones” is common among athletes and gym-goers who use creatine to boost strength and recovery. Misinformation often links creatine to kidney problems because creatine supplementation raises creatinine levels, a blood marker clinicians use to assess kidney function. This connection can spook users, but the relationship is not straightforward.

This article reviews the evidence, explains biological mechanisms, identifies who might be at risk, and gives practical steps you can take to use creatine safely. You will get clear timelines, dose recommendations, product comparisons with prices, lab tests to monitor, and a checklist to reduce stone risk. The goal is to separate myth from fact so you can make an informed decision about creatine while protecting kidney health and optimizing performance.

can creatine cause kidney stones

Short answer: for healthy people with normal kidney function, the available evidence does not show that recommended creatine doses (3 to 5 grams per day) cause kidney stones.

Creatine is converted nonenzymatically to creatinine in the body at a small rate. Creatinine is a waste product measured in blood to estimate glomerular filtration rate (GFR). Supplementation raises serum creatinine without necessarily impairing actual GFR.

That biochemical effect has led to confusion: elevated creatinine does not automatically mean kidney damage.

Kidney stones are most commonly calcium oxalate stones, followed by uric acid stones. Creatine does not supply oxalate, and it is not a direct precursor to calcium or oxalate. A more plausible mechanism for stone formation would be dehydration or changes in urine composition that increase concentrations of stone-forming minerals.

Because some athletes dehydrate for weight classes or training, any supplement that decreases thirst or increases water loss could indirectly raise stone risk. Creatine itself tends to increase intracellular water retention, which can slightly reduce urine volume if someone does not increase fluid intake. Reduced urine volume concentrates stone-forming compounds.

Case reports exist that link creatine with acute kidney injury or stones, but these are rare and often involve confounding factors such as pre-existing kidney disease, very high doses, or concomitant use of nephrotoxic drugs or untested supplements. Large randomized controlled trials and long-term observational studies in healthy adults using standard maintenance doses (3 to 5 g/day) generally show no increased incidence of kidney stones or clinically significant declines in renal function.

Actionable takeaway: if you have normal baseline kidney tests and follow recommended dosing with adequate hydration, creatine is unlikely to cause kidney stones. If you have a history of kidney stones, chronic kidney disease, or metabolic disorders, consult a physician before starting creatine and consider specific urine testing.

Why creatine is blamed for kidney stones

Several mechanisms and misunderstandings lead people to suspect creatine causes kidney stones. First, the blood marker problem: creatine supplementation increases serum creatinine. Clinicians often use serum creatinine to calculate estimated glomerular filtration rate (eGFR), an index of kidney function.

When creatinine rises, eGFR appears to fall, which may be misinterpreted as new or worsening kidney disease.

Second, fluid balance and urine concentration matter for stones. Kidney stones form when urine becomes supersaturated with stone-forming compounds. Dehydration is the single biggest modifiable risk factor for stone formation.

Creatine causes water retention inside muscle cells, which can, in some people, reduce the water left in the urine if total fluid intake does not increase. Athletes who train hard and do not compensate with extra fluids may therefore concentrate urine and increase stone risk, but creatine is not the direct cause.

Third, case reports and media stories add to the fear. Isolated reports of kidney injury or stones occurring during creatine use often lack complete medical details, and many involve other risk factors such as high-protein diets, excessive supplement stacks, nonsteroidal anti-inflammatory drug (NSAID) use, or pre-existing conditions. Single cases do not establish causation.

Fourth, product purity matters. Contaminated supplements containing heavy metals, steroids, or other adulterants can damage kidneys or alter urine chemistry. Using untested, low-quality products increases risk compared with using a third-party tested creatine monohydrate powder.

Finally, misunderstanding of types of stones and biochemical pathways contributes to the myth. Most stones are calcium oxalate; creatine is unrelated to oxalate metabolism. Uric acid stones are influenced by high levels of uric acid, often due to high-purine diets or gout; creatine does not substantially increase uric acid in most users.

Practical point: the blame often falls on creatine because it is a visible, active choice people are making, unlike dehydration or drug interactions that may be overlooked. Addressing hydration, product quality, baseline health status, and dosing clears up the confusion and reduces risk.

What the research and clinical data say

Randomized controlled trials (RCTs), meta-analyses, and long-term follow-ups give a clear signal: in healthy adults, creatine monohydrate at recommended doses is not associated with increased kidney stone risk or clinically meaningful declines in renal function.

Examples and numbers: many clinical studies use a loading phase of 20 grams per day for 5 to 7 days followed by 3 to 5 grams per day maintenance. Trials lasting from 28 days to 5 years have monitored serum creatinine, blood urea nitrogen (BUN), and estimated GFR. Except for expected rises in serum creatinine reflecting higher creatinine production, most trials report no statistically significant changes in GFR or kidney-related adverse events compared with placebo.

Several meta-analyses pooling data from multiple trials have concluded no adverse renal effects in healthy subjects. However, study populations usually exclude people with known kidney disease, so the safety profile for that group remains less certain.

Clinical case reports that suggest creatine-related stones or kidney injury are useful flags but are insufficient to change population-level risk assessments. For example, isolated reports where individuals used extremely high doses (above 20 g/day for prolonged periods), combined creatine with untested multi-ingredient supplements, or had underlying renal disorders are poor evidence of risk for the average user.

Monitoring strategies used in research translate to real-world safety measures:

Baseline labs: a basic metabolic panel (BMP) including serum creatinine and blood urea nitrogen.
Ongoing checks: repeat labs at 4-12 weeks after starting and periodically thereafter if you plan long-term use.
Urine testing: a 24-hour urine stone profile for people with a stone history.

Statistical perspective: kidney stone lifetime risk in the general population is roughly 10-15%. No RCT has shown a meaningful increase in that baseline risk from standard creatine use. The most common modifiable risk factor for stones remains low urine volume, not creatine itself.

Clinical guidance summary: healthy athletes can use creatine safely at recommended doses, with basic baseline labs and sensible hydration. Those with prior stones or kidney disease require individualized evaluation and possible nephrology referral.

Practical strategies to use creatine safely

Adopt these evidence-based steps to minimize any kidney-stone risk while getting performance benefits.

Choose dose and protocol

Recommended maintenance dose: 3 to 5 grams per day. This dose gives near-maximal intramuscular creatine stores.
Optional loading: 20 grams per day split into four 5 g doses for 5-7 days speeds saturation but is not required.
Avoid prolonged very high doses (above 10 g/day long-term) unless supervised by a clinician.

Hydrate deliberately

Aim for urine that is pale yellow. That is a simple visual marker of adequate hydration.
Baseline guideline: about 35-45 mL per kg bodyweight per day, adjusted by training, heat, and sweat losses. For a 80 kg athlete, that is ~2.8 to 3.6 liters per day.
Increase fluid intake on training or hot days; consider 500-1000 mL extra per hour of heavy sweating.

Pick third-party tested creatine

Use creatine monohydrate with Creapure or reputable brands: Optimum Nutrition Micronized Creatine Powder, BulkSupplements Creatine Monohydrate, Kaged Muscle CREATINE HCl or Myprotein Creapure.
Look for certifications: NSF International Certified for Sport, Informed-Sport, or third-party testing by Labdoor. These reduce contamination risk.

Monitor with labs

Baseline: basic metabolic panel (BMP) to get serum creatinine, BUN, electrolytes.
Recheck at 4 to 12 weeks after starting creatine, then annually if continuing long-term.
If you have a history of stones, request a 24-hour urine stone risk profile and consider more frequent monitoring.

Address diet and medications

Reduce excess sodium and limit very high oxalate foods if you are stone-prone.
Avoid unnecessary NSAIDs and nephrotoxic drugs while starting a supplement program; discuss prescription medications with your provider.

What to do if you develop symptoms

Symptoms of stones: sudden flank pain, blood in urine, nausea, or fever. Seek immediate medical care.
If serum creatinine rises significantly from baseline or symptoms occur, stop creatine and consult a physician promptly.

Examples and timeline

Week 0: get BMP, start 5 g/day maintenance creatine, begin hydration plan.
Week 4: repeat BMP; if stable, continue and recheck every 6-12 months.
Ongoing: if training increases or you travel to hot climates, add 500-1000 mL/day extra fluids.

These steps keep risk minimal while maintaining the performance benefits creatine provides for strength, power, and recovery.

Tools and resources

Use these platforms, products, and services to choose safe creatine and monitor kidney health. Prices are approximate and US-based retail ranges as of 2025.

Supplement brands and products

Optimum Nutrition Micronized Creatine Powder (300 g): $15 to $25. Widely available at Amazon, Bodybuilding.com, and GNC.
BulkSupplements Creatine Monohydrate (500 g): $20 to $30. Good for bulk buyers; available directly from BulkSupplements.
Myprotein Creatine Monohydrate Creapure (250-500 g): $10 to $25. Creapure is a German-patented form with strong purity controls.
Kaged Muscle Creatine HCl (60-120 servings): $25 to $40. Alternative form marketed as more soluble, but evidence for superiority is limited.
Thorne Creatine (90 capsules or powders): $30 to $50. Thorne emphasizes clinical-grade manufacturing.

Third-party testing and verification

NSF International Certified for Sport: look for the NSF mark on the label; certified products are tested for banned substances.
Informed-Sport/Informed-Choice: testing for athletes competing under anti-doping rules.
Labdoor: independent lab testing and rankings; free access to lab results on their website.

Laboratory testing for kidney function and stones

Basic Metabolic Panel (BMP): includes serum creatinine and BUN. Price: $20 to $150 out-of-pocket depending on lab/clinic and insurance.
24-hour urine stone profile: $150 to $400 depending on lab and number of analytes.
eGFR calculation is typically provided with BMP results.

Apps and hydration trackers

MyFitnessPal: log fluids and nutrition; free with paid features.
Gatorade Gx App or Hydration apps like WaterMinder: reminders and tracking; $0 to $5/month for premium features.
TrainingPeaks or Final Surge: training platforms with note-taking to track supplements and symptoms; free plus paid tiers.

Where to get medical advice

Primary care physician for baseline BMP and interpretation.
Nephrologist (kidney specialist) if past kidney disease or stones; consultation fees vary, typically $150 to $400 per visit without insurance.
Registered dietitian for diet modification to reduce stone risk; sessions $60 to $150 per visit.

Quick comparison - price per 30-day supply (approximate)

Optimum Nutrition creatine (5 g/day): 300 g tub = 60 servings -> $0.25 to $0.40 per serving, $7.50 to $12 per month.
BulkSupplements (5 g/day): 500 g = 100 servings -> $0.20 to $0.30 per serving, $6 to $9 per month.
Kaged Muscle (higher price): ~$0.40 to $0.60 per serving, $12 to $18 per month.

These tools and resources help you select quality creatine, track hydration, and monitor kidney function in a cost-effective way.

Common mistakes

Confusing creatinine increases with kidney damage

Mistake: stopping creatine because lab creatinine rises.
How to avoid: interpret creatinine alongside clinical context, urine output, and eGFR trends; consult your physician before stopping or changing doses.

Not increasing fluids when starting creatine

Mistake: keeping the same fluid intake despite creatine-related intracellular water shifts.
How to avoid: adopt a hydration routine, target pale-yellow urine, and add 500-1000 mL extra on heavy training days.

Using untested or contaminated supplements

Mistake: buying cheap powders without third-party certification.
How to avoid: buy brands with NSF or Informed-Sport certification or products tested by Labdoor. Prefer Creapure or well-known manufacturers.

Long-term excessive dosing

Mistake: staying on a 20 g/day loading dose for weeks or months.
How to avoid: after loading (if used) switch to 3-5 g/day maintenance. If you want higher dosing, discuss with a clinician and monitor labs.

Ignoring personal medical history

Mistake: assuming creatine is safe without checking for kidney disease or stone history.
How to avoid: get baseline labs and disclose supplement use to your healthcare provider; if you have prior stones or renal disease, get personalized guidance.

FAQ

Will Creatine Make My Creatinine Test Abnormal?

Creatine supplementation commonly raises serum creatinine because creatine converts to creatinine. This rise can make lab values appear abnormal even when kidney function is unchanged. Discuss results with a clinician who understands supplementation.

If I Had a Kidney Stone Before, Can I Still Take Creatine?

You may be able to, but consult your doctor first. Get a 24-hour urine stone profile and follow targeted dietary and hydration strategies before starting creatine.

How Much Water Should I Drink When Using Creatine?

Aim for pale-yellow urine as a practical target. A baseline guideline is 35-45 mL per kg bodyweight per day; for an 80 kg athlete, that is about 2.8 to 3.6 liters. Increase intake during heavy training, heat, or sweating.

What Dose of Creatine is Considered Safe?

Standard maintenance dosing is 3 to 5 grams per day. An optional loading phase of 20 g/day for 5-7 days speeds saturation but is not required. Avoid prolonged very high doses unless supervised.

Are Some Types of Creatine Safer than Others?

Creatine monohydrate, especially Creapure-branded monohydrate, has the largest body of safety data and is generally the recommended choice. Other forms like creatine hydrochloride (HCl) are marketed for solubility but lack superior safety evidence.

Do I Need to See a Nephrologist Before Starting Creatine?

Not usually if you are healthy and have no history of kidney disease. Get a baseline basic metabolic panel; if results are abnormal or you have prior stones or kidney disease, see a nephrologist.

Next steps

Get baseline labs: schedule a basic metabolic panel (BMP) that includes serum creatinine and BUN before starting creatine.
Choose a quality product: buy creatine monohydrate from Creapure or brands verified by NSF International or Informed-Sport. Expect to pay $6 to $15 per month for a standard dose.
Start a hydration plan: set a daily fluid target based on bodyweight (35-45 mL/kg) and monitor urine color; add 500-1000 mL extra on heavy training days.
Recheck labs: repeat BMP in 4 to 12 weeks after starting creatine, and annually thereafter if you continue long-term, or sooner if you have symptoms.
If you have a history of stones or kidney disease, obtain a 24-hour urine stone profile and consult a nephrologist for personalized guidance.

This structured approach balances the performance advantages of creatine with practical protections for kidney health and stone prevention.

Can Creatine Cause Kidney Stones - Facts and Guidance