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Renal biopsy showing revealed focal tubular injury with dilatation of tubular lumina and flattening of the tubular epithelial cells.
Source publication
We report a case of a heretofore healthy 18-year-old man who presented with a 2-day history of nausea, vomiting and stomach
ache while taking creatine monohydrate for bodybuilding purposes. The patient had acute renal failure, and a renal biopsy
was performed to determine the cause of increased creatinine and proteinuria. The biopsy showed acute tu...
Context in source publication
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Purpose
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Citations
... Also, Puma was led to histological lesions in liver, that included necrosis, fibrosis, congestion of central vein, hemorrhage as well as hypertrophy of hepatocytes with increasing of sinusoids. All these changes were observed may be linked to intake of Puma fattened at irregular and large doses, this accordance with Taner et al. (2010) who indicated to damages of kidney are occur when treatment with supplements. Blach (2010) reported to important role of nutritional supplements components which cause renal damages and histological lesions of kidney. ...
... Günümüze gelindiğinde ciddi araştırmalarda kreatinin kullanım şekli ve dozajına bağlı olarak böbrek üzerinde zararlı etkilerinin olmadığı neredeyse ortak görüş haline gelmiştir. Ancak böbrek fonksiyon bozukluğu olan bireylerde kreatin kullanımı tavsiye edilmemektedir (E Silva et al., 2019;Taner et al., 2011). ...
Vücut geliştirme; yıllarca süren kuvvet antrenmanlarıyla sporcunun estetik bir şekilde kas kütlesini arttırmaya ve vücut yağ oranını minimum düzeyde tutmaya odaklanarak yapılan, sporcunun kas görünümüne göre değerlendirildiği bir spor branşıdır (Montuori et al., 2021). Diğer bir ifadeye göre de vücut geliştirme; hareket ve antrenman bilimine bağlı olarak belirli bir plan içinde bedenin gelişimi, kasların kuvvetlenmesi ve dayanıklılığın artması ile vücudun görünüş yönünden en yüksek seviyeye ulaştırılma çabasıdır. (Hartgents et al., 2001). Vücut geliştirmenin estetik kazandırma, organizmanın sistemleri geliştirme, bedensel zindelik kazanımı, kas kontrolü, denge ve konsantrasyonu artırma gibi katkıları mevcuttur (Yalnız ve Gündüz, 2004). Vücut geliştirme, amaca yönelik çalışma prensibine dayalı bir branştır ve vücut ağırlığı, serbest ağırlık ve makine egzersizleri ile kas kütlesinin arttırılmasını amaçlamaktadır (Schoenfeld et al., 2020). Vücut geliştirme yüzyıllardır var olmasına rağmen, 20. yüzyılda 1965'teki ilk Mr. Olympia yarışmasıyla rekabetçi bir spor olarak popülerlik kazanmıştır. O zamandan bu yana milyonlarca takipçisi ve milyar dolarlık bir endüstrisi ile küresel bir fenomen haline gelmiştir (Mantri et al., 2023).
Her sporda olduğu gibi vücut geliştirme sporunda da elit ya da elit olmayan sporcular performansı artırıcı yöntem ve uygulamaların kullanımı tercih etmektedirler. Egzersiz performansına katkı sağlayan bu yöntem ve uygulamalar ergojenik destek veya ergojenik ajan olarak adlandırılmaktadır. Vücut geliştirme sporunun artan popülaritesi performans artırıcı takviye kullanımının yaygınlaşmasını sağlamıştır. Artan takviye kullanımı da beraberinde olumlu katkıların yanı sıra çeşitli sorunlar olarak sporcuların karşısına çıkmaktadır. Takviye kullanımlarında ki bilinçsiz yöntemler ve etkileri kanıtlanmamış uygulamalar kısa ya da uzun sürede, akut veya kronik olarak zararlı yan etkileriyle ciddi problemler oluşturmaktadır. Bu nedenlerle bu bölümde vücut geliştirme sporcularının ergojenik ajan kullanımlarında güncel yaklaşımlar ve gelişmeler incelenmiştir.
... Nonetheless, the potential adverse effects of creatine, particularly on kidney, are still a matter of debate. The first concerns regarding the possible harms of creatine supplementation to kidney came from a series of case studies that have retrospectively associated its use with kidney conditions [15][16][17][18][19][20][21]. In addition, some animal studies also cast doubt on the safety of creatine supplementation [22][23][24]. ...
... There have been a number of case studies ( Table 2) associating creatine supplementation with kidney dysfunction [15][16][17][18][19][20][21]72]. Nonetheless, as discussed below, many of them have severe limitations that undermine their conclusions. ...
... It is worth noting that this patient had been using creatine monohydrate within recommended dosages along with large amounts of numerous other dietary supplements for bodybuilding purposes (e.g., amino acids, multiple herbal and non-herbal supplements, and vitamins) and had an unusual high-intensity training regimen (3 h of strenuous exercise 5 times per week), which altogether limits the assumptions of the nephrotoxic effects of creatine per se. Taner et al. (2011) reported the case of an 18-year-old bodybuilder who presented with acute tubular necrosis after taking creatine monohydrate within recommended dosages for approximately 7 weeks [21]. However, the authors acknowledge that no previous study had associated creatine supplementation with such a condition. ...
Creatine has become one of the most popular dietary supplements among a wide range of healthy and clinical populations. However, its potential adverse effects on kidney health are still a matter of concern. This is a narrative review of the effects of creatine supplementation on kidney function. Despite a few case reports and animal studies suggesting that creatine may impair kidney function, clinical trials with controlled designs do not support this claim. Creatine supplementation may increase serum creatinine (Crn) concentration for some individuals, but it does not necessarily indicate kidney dysfunction, as creatine is spontaneously converted into Crn. Based on studies assessing kidney function using reliable methods, creatine supplements have been shown to be safe for human consumption. Further studies with people who have pre-existing kidney disease remain necessary.
... Bodybuilding supplements are commonly cited as a cause of morbidity. There is one case report of venous thromboembolism in a 24-year-old strength-trained individual who was ingesting 20 g of creatine in preparation for a bodybuilding competition [129], and other similar cases of severe renal dysfunction in otherwise healthy young adults [130][131][132][133]. Such case reports assume a cause-and-effect relationship, yet a wide body of research indicates that creatine is safe at the levels ingested [134]. ...
Premature deaths in bodybuilders regularly make headlines and are cited as evidence that bodybuilding is a dangerous activity. A wealth of research has revealed elite athletes typically enjoy lower mortality rates than non-athletes, but research on bodybuilder lifespan is surprisingly limited. Anabolic androgenic steroid (AAS) use is commonly cited as a key contributor to morbidity and premature mortality in bodybuilders, but this area of research is highly nuanced and influenced by numerous confounders unique to bodybuilding. It is quite possible that bodybuilders are at elevated risk and that AAS use is the primary reason for this, but there remains much unknown in this realm. As global participation in bodybuilding increases, and healthcare providers play a more active role in monitoring bodybuilder health, there is a need to identify how numerous factors associated with bodybuilding ultimately influence short- and long-term health and mortality rate. In this Current Opinion, we discuss what is currently known about the bodybuilder lifespan, identify the nuances of the literature regarding bodybuilder health and AAS use, and provide recommendations for future research on this topic.
... On the other hand, some case reports suggested that CMS could affect kidney function in some situations. Nonetheless, these studies have severe limitations that makes it difficult to draw valid conclusions, such as short-term creatine supplementation [5], no evaluation of the patient's condition prior to the supplementation [14], use of other types of supplements [15], and having a history of renal damage [16]. ...
Introduction:
Several studies examined the effects of creatine monohydrate supplementation on renal function, but no previous study has investigated its effects on kidney stones in humans.
Observation:
A renal ultrasound in a healthy young athlete (without a known renal morphological anomaly, normal kidney function, normal phospholipid and uric acid data) revealed a kidney stone of 11 mm in the lower right calyx. Extracorporeal shock wave lithotripsy was applied in order to break the down stone. Twentyone days later, a follow-up renal ultrasound showed the absence of stones in the kidney. One week later, the athlete started creatine monohydrate supplementation for two months. Fourteen months after stopping creatine monohydrate supplementation, a third renal ultrasound confirmed the absence of stones in the kidney.
Conclusion:
Two months of creatine monohydrate supplementation in an athlete with a history of kidney stones could not be associated with kidney stone recurrence in the long run.
... The literature still discusses creatine as a dietary supplement, albeit less frequently (De Souza e Silva et al., 2019;Antonio et al., 2020;Clarke et al., 2020). Some studies have reported that the compound can have adverse effects on Kidneys function (Thorsteinsdottir, 2006;Taner et al., 2011). On the other hand, other researchers have not determined the risk of renal damage, and episodes of nephrotoxicity are rare in healthy patients supplemented with Creatine (Gualano et al., 2008;Gualano et al., 2011;Domingues et al., 2020). ...
Creatine is a substance found naturally in body tissues, especially in the muscles and brain. Creatine is found in the diet, especially in seafood and red meat, and is commonly used to increase muscle mass and improve exercise performance in humans. This research was design to evaluate the effects of creatine administration on many physiological and biochemical parameters. In the method design, 24 mature adult male rabbits are divided at random into four groups as the following: G1 (Group of control): six mature adult of male rabbits orally administered distilled H2O (1ml/animal) by gavage daily, G2 mature adult of male rabbits were orally administration creatine monohydrate (1ml/kg BW) by gavage daily. G 3 mature adult of male rabbits were orally administration creatine monohydrate (2ml/kg BW) by gavage daily. While G4 adult male rabbits were orally administration creatine monohydrate (3ml/kg BW). After 30-days of administration, the rabbits were anaesthetized and blood samples were collected for determination thyroid hormones, liver enzymes, lipid profiles and kidney function (determined by urea, creatinine levels) and serum total protein levels, in the results, the groups that received 1, 2 and 3 ml of creatinine significantly increased but more over increased in group treated with 3 ml of creatinine in all studied parameters such as T4 hormones, liver enzymes, urea, creatinine levels and all lipid profile except TSH, T3, HDL, total protein concentration decreased significantly compared to the control group. In conclusions, the creatine has harmful effect on biochemical and physiological parameters in the creatine-treated group (3ml). In the conclusion that an adverse effect of creatine on the functions of the thyroid gland, liver and kidneys increases in these organs with increase doses.
... In Brazil the prescription of dietary supplements is a professional practice exclusive to nutritionists and physicians, and cannot be performed by other professionals, including physical educators (Brazilian Federal Council of Nutrition, 2020). However, popularity of supplement intake by gym users along with easy access to them and evokes a question about their consumption, as the indiscriminate use of these resources may cause significant damage to several body systems (Maughan et al., 2018), including the liver (Solimini et al., 2017) and kidney (Taner et al., 2011). ...
Objective
Dietary supplement use is popular among gym users. However, there is a lack of understanding about their use. This study investigated the relationship between dietary supplement use and associated factors among gym users from Southern Brazil.
Methods
This is a cross-sectional study including gym users (n = 543; 18–59 years old). Subjects answered an online questionnaire concerning demographic, lifestyle and sports practice questions, and dietary supplement use. Pearson chi-square test was used with a significance level of p < .05.
Results
The prevalence of dietary supplement use was 36.5%. Supplement users were mostly men (54.5%; p < .001), exercised 3–5 times a week (73.2%; p < .001) and had trained for longer than one year (55.4%, p < .05). Men reported more frequently self-prescribed dietary supplement use (42.6%), while women reported supplements use prescribed by nutritionists (35.6%; p < .01). The use to gain mass (p < .05), to improve performance (p < .01), and to improve body aesthetics (p < .05) were associated with sex. Supplements categorized as sport foods (84.3%; p < .05) were the most frequently consumed supplements by both sexes.
Conclusion
Supplement users were more likely to be men, to use sport foods, and to have as a goal to increase muscle mass. Moreover, men are more likely to self-prescribe dietary supplements, while women tend to obtain information from nutritionists.
... Seven studies have identified creatine use in bodybuilders with renal dysfunction, although only five outlined specific dosing strategies (Table 1). Maintenance doses consumed were variable with respect to those recommended [25,[41][42][43]. In an extreme case it was reported that the individual consumed 210 g/day, which is 22 times greater than the recommended maintenance dose [26]. ...
... Again, creatine supplementation was rarely used in isolation. Only one study [41] specifically stated denial of use of AAS, NSAIDS and diuretics, while two studies did not mention any other bodybuilding practices, such as nutritional intake or use of other agents [42,43]. The kidney conditions most frequently associated with creatine supplementation in bodybuilders are acute interstitial nephritis (AIN) and acute tubular necrosis (ATN), which have occurred in individuals consuming relatively low doses [42,43]. ...
... Only one study [41] specifically stated denial of use of AAS, NSAIDS and diuretics, while two studies did not mention any other bodybuilding practices, such as nutritional intake or use of other agents [42,43]. The kidney conditions most frequently associated with creatine supplementation in bodybuilders are acute interstitial nephritis (AIN) and acute tubular necrosis (ATN), which have occurred in individuals consuming relatively low doses [42,43]. It is possible that other agents were also being consumed-though none were reported-or that excipients in the creatine preparations were the real culprits. ...
Bodybuilders routinely engage in many dietary and other practices purported to be harmful to kidney health. The development of acute kidney injury, focal segmental glomerular sclerosis (FSGS) and nephrocalcinosis may be particular risks. There is little evidence that high protein diets and moderate creatine supplementation pose risks to individuals with normal kidney function though long-term high protein intake in those with underlying impairment of kidney function is inadvisable. The links between anabolic androgenic steroid use and FSGS are stronger, and there are undoubted dangers of nephrocalcinosis in those taking high doses of vitamins A, D and E. Dehydrating practices including diuretic misuse, and NSAID use also carry potential risks. It is difficult to predict the effects of multiple practices carried out in concert. Investigations into sub-clinical kidney damage associated with these practices have rarely been undertaken. Future re-search is warranted to identify clinical and subclinical harm associated with individual practices and combinations to enable appropriate and timely advice
... Studies have reported that the consumption of supplements such as creatine, protein, vitamins and sport drinks may lead to an acute kidney injury (21) . The studies analysed associated creatine supplementation with renal function impairment (22,23) ; however, the conclusions regarded only one patient, requiring, therefore, a cautious interpretation. Another study reported that liver injury cases (modest increases in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values) could be attributed to dietary and medical supplements including vitamins, minerals and botanical extracts (24) . ...
Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study with 594 gym users (mean age 37±14 years, 55.2% women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase; ALT, aspartate aminotransferase; AST, alkaline phosphatase; AKP, gamma-glutamyltransferase; Gama-GT) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analyzed by Binary Logistic Regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36.0%. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.
... A daily turnover of creatine is approximately 2.0 grams, and about half of this daily need for creatine (1.0 g/day) is obtained from the diet, while the rest is de novo synthesized inside the body. Creatine is generally considered a safe nutritional compound (Balestrino & Adriano, 2019), yet several case reports suggest that high levels of creatine in a diet may compromise kidney function (Taner et al. 2011;Thorsteinsdottir et al. 2006). In contrast, a plethora of randomized controlled studies reported no damaging effects of dietary creatine on renal function (for a detailed review see Souza et al., 2019). ...
Consuming more creatine may be associated with an increased risk of renal dysfunction, yet this link remains poorly addressed at the population level. Using 2017–2018 NHANES data, the current study found that the odds ratio for having failing kidneys in 2,955 U.S adults consuming ≥2.0 g/day of dietary creatine compared to low‐intake counterparts (<1.0 g/day) was 0.74 (95% CI from 0.39 to 1.38), indicating no significant association between dietary creatine intake and kidney dysfunction. This population‐level study revealed no relationship between consuming more creatine and kidney failure in U.S. adults. It appears that high‐creatine consumers, who eat about 5 times more creatine per day than their low‐creatine peers, show no higher risk of kidney failure.
