No trial has been designed to test whether creatine causes kidney stones — but one long trial counted them anyway. NET-PD LS-1, the largest creatine trial ever run, gave 10 g a day or placebo to 1,741 people for a median of about four years and posted every serious adverse event: kidney stones in 2 of 874 on creatine and 6 of 867 on placebo. Beyond that, the literature holds one case report, the FDA's database four reports among 210, and the American Kidney Fund's 2026 creatine article does not mention stones at all.
This page counts what exists, explains why the chemistry gives no direct route from creatine to the common stone types, and names who should ask a clinician before starting. It does not reassure anyone that creatine is safe for a stone former; nobody has studied that.
What the literature holds
PubMed was searched on 27 October 2026 for creatine and supplementation together with nephrolithiasis, urolithiasis, renal calculi, kidney stone or kidney stones in the title or abstract. It returned 4 records:
| Record | Type | About creatine and stones? |
|---|---|---|
| Akbari et al. 2022, Tunis Med (PMID 36206067) | Case report, 1 athlete | Yes — the only one |
| Brown 2017, Food Chem Toxicol (PMID 28755953) | Table of kidney-toxicity case reports for supplements | No — a catalogue across many supplements |
| Battini et al. 2017, Orphanet J Rare Dis (PMID 28148286) | 15-year follow-up of a rare creatine-synthesis disorder | No — creatine as treatment for a genetic disease |
| Feehally & Khosravi 2015, Nutr Rev (PMID 26290296) | Review of dehydration and kidney health | No — creatine is not its subject |
ClinicalTrials.gov, searched the same day for creatine with kidney stone and with nephrolithiasis, returned 9 and 6 records. None tests a creatine supplement; each uses creatinine as a kidney measure in a trial of something else — stone-dissolving drugs, a diabetes medicine, a weight-loss diet. There is no registered trial designed to answer the question; the stone counts that exist come from the adverse-event tables of a trial about something else, below.
The large safety analysis of 685 creatine trials published in 2025 reports side effects across 49 categories and found no excess over placebo (creatine side effects has the breakdown). Those trials were not designed to look for stones, and most lasted weeks rather than the years over which stone recurrence is usually followed.
The one trial that counted stones
NET-PD Long-term Study 1 (NCT00449865) randomised 1,741 people with early Parkinson disease across 45 sites in the United States and Canada to 10 g of creatine monohydrate a day or placebo. It was stopped for futility on its Parkinson outcome after a median of about four years, and its results, including every serious adverse event, are posted on ClinicalTrials.gov. The kidney-stone lines, read on 27 October 2026:
| Serious adverse event (NET-PD LS-1) | Creatine, 10 g/day (n = 874) | Placebo (n = 867) |
|---|---|---|
| Nephrolithiasis (kidney stones) | 2 | 6 |
| Renal colic | 0 | 2 |
What it shows: over years of use at twice the amount most people take, stones serious enough to be recorded as serious events were not more common on creatine than on placebo in this group. What it cannot show: the participants were older adults with Parkinson disease, not lifters; only serious events are tabulated for stones, so milder episodes may be missing; stones were not a planned outcome and were not screened for by scan; eight events in total is too few to rule out a modest effect either way; and people with a history of stones were not studied as a group. The full adverse-event picture from this trial is on is creatine bad for you.
The one case, read in full
Akbari and colleagues (2022) describe a healthy young athlete with normal kidney function, normal uric acid and no structural kidney abnormality, in whom an ultrasound found an 11 mm stone in the lower right calyx. Shock-wave lithotripsy broke it up; an ultrasound 21 days later showed no stone. One week after that, the athlete began creatine monohydrate and took it for two months. An ultrasound 14 months after stopping showed no stone.
What it can show: in one person with a previous stone, two months of creatine was not followed by a new stone visible on ultrasound over the next 14 months. What it cannot show: anything about other people, longer use, other stone types, or how close the athlete came — the abstract reports no urine chemistry (volume, oxalate, citrate, calcium) during or after creatine, and the amount taken is not given in the abstract. The authors' own conclusion is that the episode "could not be associated" with recurrence. Their introduction states that no previous study had investigated creatine and kidney stones in humans; the stone counts in the Parkinson trial above were never published as a study of that question.
The chemistry: what stones are made of
The American Kidney Fund's stone guide gives the US mix:
- Calcium stones — calcium oxalate (most of them) or calcium phosphate — about 4 in 5 cases.
- Uric acid stones — about 1 in 10.
- Struvite stones, linked to infection, and cystine stones from an inherited disorder, cystinuria — the rest.
Creatine follows a different path. The body converts it, slowly and without enzymes, into creatinine, which the kidneys filter and pass in urine; supplementation raises urinary creatinine (the arithmetic is on what is creatine in bloodwork). Creatinine is not oxalate, urate, phosphate or cystine, and it is not a recognised stone component. That is why no one has proposed a direct chemical route from a creatine supplement to the common stone types — and also why the absence of a route is not the same as evidence of no effect. A supplement could, in principle, change stone risk indirectly, through urine volume, urine pH or diet, and none of those has been measured in stone formers taking creatine.
Urine volume, the indirect route
Low urine output is one of the best-documented risks for every stone type, which is why "does creatine dehydrate you" matters here. In the trials that measured it, creatine raised total body water, and a 2009 meta-analysis of ten randomised trials found no evidence that it hinders heat tolerance or fluid balance; the full count, and the separate questions of urination, thirst and cramps, are on creatine and dehydration. The American Kidney Fund's dietitian, in its 2026 article, calls creatine-caused dehydration "a widespread misconception".
What has not been measured: 24-hour urine volume or stone-risk chemistry (supersaturation of calcium oxalate, urine citrate) in people taking creatine. Those are the measurements a urologist would use, and no study reports them.
What the FDA's reports show
The FDA's food and supplement adverse-event database (CAERS), queried on 27 October 2026, holds 210 reports naming a product with "creatine" in its brand name. Of those, 4 list a kidney or ureteric stone:
| Received | Reaction coded | Creatine product's role | Outcome recorded |
|---|---|---|---|
| 2013 | Nephrolithiasis (with congenital cystic kidney disease) | Only suspect, among 4 products | Other serious event |
| 2013 | Ureteric calculus | Only product named | Emergency visit |
| 2018 | Nephrolithiasis | One of 7 suspect products | Hospitalisation |
| 2026 | Nephrolithiasis | Concomitant only (2 other suspects) | Hospitalisation, life-threatening |
Two reports name a creatine product as the only suspect; both are from 2013 and both name the same branded creatine product. One of the two also records a congenital cystic kidney disease, a condition that itself affects the kidneys. Across all 210 creatine reports, 23 code any kidney or renal reaction.
A CAERS report records that someone linked a product and an event; it does not establish that the product caused it, carries no count of how many people took the product without incident, and cannot be turned into a rate. Product names in the reports are not reproduced here.
Who has published a position
- American Kidney Fund (13 August 2026, Q&A with a dietitian from its advisory group, medically reviewed): for generally healthy people, studies have not shown that a standard amount — the article says under 5 grams a day — harms kidney function; people with kidney disease, high blood pressure, diabetes or heart disease should talk to their doctors before any supplement; and creatine raises creatinine, so a doctor should know before blood work. The article does not mention kidney stones.
- The 2025 safety analysis of 685 trials found no significant differences in markers of renal function between creatine and placebo groups; stones are not among the outcomes reported on creatine side effects.
Who should ask a clinician first
On what the American Kidney Fund publishes, and on what has never been studied, the people for whom this is a clinician's question rather than a reader's are: anyone with a previous stone (the stone's type changes the advice), chronic kidney disease, a single kidney, a congenital kidney condition, or a condition the fund lists alongside kidney disease — high blood pressure, diabetes, heart disease. A clinician who knows the stone type and the urine chemistry can say what this page cannot.
What is not established
- Whether creatine supplements change the risk of a first stone or a recurrence in healthy adults or stone formers — no trial designed for it, no cohort; the one long trial's 2-versus-6 count is in older adults with Parkinson disease and serious events only.
- Whether creatine changes urine volume, pH, oxalate, citrate or calcium in stone formers — not measured.
- Whether some creatine products differ from others in this respect — not studied; that both single-suspect FDA reports name the same product proves nothing either way.
The filtration question — whether creatine harms kidney function in general — is a separate one with more evidence behind it, set out on creatine and kidneys. Blood-test confusion is covered on what is creatine in bloodwork and muscle-damage markers on creatine kinase. The wider long-term safety record is on the creatine safety page.
Sources and dates
- PubMed search via NCBI E-utilities, 2026-10-27:
creatine[tiab] AND (nephrolithiasis[tiab] OR urolithiasis[tiab] OR "kidney stone"[tiab] OR "kidney stones"[tiab] OR "renal calculi"[tiab]) AND (supplement*[tiab] OR supplementation[tiab])— 4 records. - Akbari HA et al. (2022), Effect of creatine supplementation on kidney stones recurrence in an athlete: a case report, Tunis Med 100(6):477–80, PMID 36206067.
- Brown AC (2017), Food Chem Toxicol 107:502–19, PMID 28755953; Battini R et al. (2017), Orphanet J Rare Dis 12:21, PMID 28148286; Feehally J, Khosravi M (2015), Nutr Rev 73 Suppl 2:110–9, PMID 26290296.
- ClinicalTrials.gov API v2, searches "creatine AND kidney stone" (9) and "creatine AND nephrolithiasis" (6), 2026-10-27.
- FDA CAERS via openFDA
food/event,products.name_brand:creatine, all 210 reports read for stone, calculus and colic reactions, 2026-10-27. - ClinicalTrials.gov, NCT00449865 (NET-PD LS-1), posted results: serious adverse events, nephrolithiasis and renal colic by arm, read via API v2 on 2026-10-27.
- American Kidney Fund, The creatine scoop — essential cautions for the kidney community, 13 August 2026, read 2026-10-27; Kidney stones, read 2026-10-27.
- Antonio J, Kreider RB et al. (2025), 685-trial safety analysis, J Int Soc Sports Nutr, PMID 40198156.