CREATINE SUPPLEMENTATION IN HEMODIALYSIS PATIENTS

Abstract

End stage renal failure patients receiving hemodialysis frequently complain of fatigue, muscle aches, weakness, lack of endurance, and cramps. Several studies have suggested that creatine supplements can improve peak performance and stamina in healthy athletes without enough conversion of creatine to creatinine to raise the blood creatinine concentration. We conducted a study to determine the safety and potential benefit of low dose creatine as a low cost dietary supplement. Six patients were enrolled. They were evaluated by psychological testing using the Kidney Disease Quality of Life Short Form, stationary bicycle riding, and blood tests before, during, and for three weeks after taking 2 g creatine per day for 1 month. The way in which the patients viewed themselves and their health did not change significantly throughout the 8 weeks of the study. Four of six patients improved their exercise performance. Of the two who did not improve, one took only 9 of the intended 34 doses of creatine and the other took creatine sporadically and not according to protocol. Electrolytes, BUN, creatinine, phosphate, liver function studies, and hematologic profiles were not significantly altered by creatine. No patient demonstrated intolerance to the supplement. We conclude that 2 g creatine daily given to dialysis patients had no important adverse effects, and for some, appeared to help their fatigue and improve their physical endurance. Based of these preliminary findings, a larger study of longer duration seems justified.