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- W1968636475 abstract "I have concerns about N R Pritchard and P A Kalra's (April 25, p 1252)1Pritchard NR Kalra PA Renal dysfunction accompanying oral creatine supplements.Lancet. 1998; 351: 1252-1253Summary Full Text Full Text PDF PubMed Scopus (170) Google Scholar report. These workers conclude that they have “strong circumstantial evidence that creatine was responsible for the deterioration in renal function”. They recorded in their patient a moderate decrease in renal function over time, which apparently coincided with a period of creatine supplementation, but he had recurring renal failure, which they largely ignore. Furthermore, to intimate that the decline in renal function was the direct result of creatine ingestion is exaggerated. Since they present no data for dietary creatine intake or urinary creatine output, and offer no rational explanation for their finding, how can they conclude that a direct cause and effect relation existed? The 2 g per day creatine maintenance dose ingested by the patient for 7 weeks before diagnosis probably contained only slightly more creatine than found in an average meat-eater's diet. Pritchard and KaLra also choose to ignore published data showing that short-term oral creatine supplementation has no effect on renal function in healthy individuals.2Poortmans JR Auquier H Renaut V Durussel A Saugy M Brisson GR Effect of short-term creatine supplementation on renal responses in men.Eur J Appl Physiol. 1997; 566: 566-567Crossref Scopus (136) Google Scholar Oral creatine supplementation would be expected to cause a rise, not a fall, in urinary creatinine output in healthy individuals. This increase correlates well with the increase in muscle creatine noted during supplementation and indicates an enhanced rate of muscle creatine degradation to creatinine.3Hultman E Soderlund K Timmons J Cederblad G Greenhaff PL Muscle creatine loading in man.J Appl Physiol. 1996; 81: 232-237PubMed Google Scholar The regimen of ingesting 20 g of creatine per day for 5–6 days has shown no obvious health risks in healthy volunteers, provided that the creatine is dissolved before ingestion2Poortmans JR Auquier H Renaut V Durussel A Saugy M Brisson GR Effect of short-term creatine supplementation on renal responses in men.Eur J Appl Physiol. 1997; 566: 566-567Crossref Scopus (136) Google Scholar (undissolved creatine may cause slight gastrointestinal discomfort). Longer high-dose creatine supplementation (20 g per day for 5 days followed by 10 g per day for 51 days) has no effect on serum markers of hepatic and renal function and routine clinical chemistry in healthy volunteers.4Earnest C Almada A Mitchell T Influence of chronic creatine supplementation on hepatorenal function.FASEB J. 1996; 10: 4588Google Scholar These data also invalidate Pritchard and Kalra's conclusion that tubular damage could have arisen “due to muscle pigment, or… increased creatine [presumably they meant creatinine] production”. Finally, the recent death of three American wrestlers has not been attributed to creatine supplementation as these workers imply. It is now accepted that the excessive weight loss procedures undertaken in an attempt to meet weight categories was responsible for the untimely deaths of these athletes.5Center for Disease Control and Prevention.Division of media relations. CDC, News, AtlantaFeb 20, 1998Google Scholar Indeed, it seems that two of the athletes had never used creatine supplements. Creatine supplements are now used worldwide by healthy individuals to attain maximum performance and training adaptations during intense exercise and by patients who have compromised muscle energy metabolism and function. Published work indicates that acute creatine ingestion is not a health risk. However, although there seems little cause for concern, it should be emphasised that no scientific data have yet been published that have specifically addressed the long-term health risks of chronic creatine ingestion. Clearly, this question needs to be investigated so that informed conclusions about its safety can be made. Renal dysfunction accompanying oral creatine supplementsAuthors' reply Full-Text PDF" @default.
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- W1968636475 title "Renal dysfunction accompanying oral creatine supplements" @default.
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