Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.

<h4>Background and hypothesis</h4>Individuals undergoing chronic hemodialysis represent a population with high morbidity and mortality, primarily due to poor nutritional status, chronic inflammation, and cardiovascular disease. However, additional factors, such as low physical activity a...

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Main Authors: Waldo Bernales-Delmon, Simón Schulz, Iván Guglielmi, Cynthia Saravia, Yasna Venegas, Jaime Joost, José Aguilar, Andrés Wulf, Paulina Bittner, María Claudia Martínez, Sandy Gómez, Catalina Chávez, Juan John, Felipe Matus, Carla Basualto-Alarcón
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0328757
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author Waldo Bernales-Delmon
Simón Schulz
Iván Guglielmi
Cynthia Saravia
Yasna Venegas
Jaime Joost
José Aguilar
Andrés Wulf
Paulina Bittner
María Claudia Martínez
Sandy Gómez
Catalina Chávez
Juan John
Felipe Matus
Carla Basualto-Alarcón
author_facet Waldo Bernales-Delmon
Simón Schulz
Iván Guglielmi
Cynthia Saravia
Yasna Venegas
Jaime Joost
José Aguilar
Andrés Wulf
Paulina Bittner
María Claudia Martínez
Sandy Gómez
Catalina Chávez
Juan John
Felipe Matus
Carla Basualto-Alarcón
author_sort Waldo Bernales-Delmon
collection DOAJ
description <h4>Background and hypothesis</h4>Individuals undergoing chronic hemodialysis represent a population with high morbidity and mortality, primarily due to poor nutritional status, chronic inflammation, and cardiovascular disease. However, additional factors, such as low physical activity and impaired functionality, have also been identified as directly associated with increased mortality.<h4>Main objective</h4>This study was conceived as a pilot study to investigate whether creatine supplementation (5g/day) for eight weeks could provide benefits in terms of physical functionality, handgrip and body composition in a group of adult patients on chronic hemodialysis. On dialysis days, creatine was administered immediately post-dialysis, while on non-dialysis days, patients took the supplement at home. Measurements were taken using bioimpedance analysis, handgrip strength (via dynamometry), and the Short Physical Performance Battery (SPPB), both before starting creatine supplementation and at week 8 of treatment.<h4>Results</h4>After performing robust statistical analysis, following creatine supplementation, an increase in SPPB scores was observed, with a mean improvement of 0.78 points [95% CI: 0.17-1.44] and an effect size of 0.53. Skeletal muscle mass increased by an average of 1.31 kg [95% CI: 0.55 to 2.23], with an effect size of 0.66. Fat-free mass showed a mean increase of 2.11 kg [95% CI: 0.75 to 3.58] with an effect size of 0.64, while phase angle rose by 0.52 degrees [95% CI: 0.27 to 0.76], corresponding to an effect size of 0.90. Regarding volumetric estimates, total body water increased by 1.17 L [95% CI: 0.26 to 2.13] with an effect size of 0.54, and intracellular water increased by 0.97 L [95% CI: 0.48 to 1.51] with an effect size of 0.81. No significant differences were observed in extracellular water with change of 0.20 L [95% CI: -0.30 to 0.70] or handgrip strength with an increment of 0.67 kgF, [95% CI: -0.67 to 2.11].<h4>Conclusion</h4>Oral creatine supplementation in HD patients for eight weeks improved muscular and functional outcomes and may be proposed as a strategy to mitigate the elevated morbidity observed in this group of patients.
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spelling doaj-art-8fff95ce210543b5bc9bcd230896b4502025-08-20T03:23:30ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032875710.1371/journal.pone.0328757Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.Waldo Bernales-DelmonSimón SchulzIván GuglielmiCynthia SaraviaYasna VenegasJaime JoostJosé AguilarAndrés WulfPaulina BittnerMaría Claudia MartínezSandy GómezCatalina ChávezJuan JohnFelipe MatusCarla Basualto-Alarcón<h4>Background and hypothesis</h4>Individuals undergoing chronic hemodialysis represent a population with high morbidity and mortality, primarily due to poor nutritional status, chronic inflammation, and cardiovascular disease. However, additional factors, such as low physical activity and impaired functionality, have also been identified as directly associated with increased mortality.<h4>Main objective</h4>This study was conceived as a pilot study to investigate whether creatine supplementation (5g/day) for eight weeks could provide benefits in terms of physical functionality, handgrip and body composition in a group of adult patients on chronic hemodialysis. On dialysis days, creatine was administered immediately post-dialysis, while on non-dialysis days, patients took the supplement at home. Measurements were taken using bioimpedance analysis, handgrip strength (via dynamometry), and the Short Physical Performance Battery (SPPB), both before starting creatine supplementation and at week 8 of treatment.<h4>Results</h4>After performing robust statistical analysis, following creatine supplementation, an increase in SPPB scores was observed, with a mean improvement of 0.78 points [95% CI: 0.17-1.44] and an effect size of 0.53. Skeletal muscle mass increased by an average of 1.31 kg [95% CI: 0.55 to 2.23], with an effect size of 0.66. Fat-free mass showed a mean increase of 2.11 kg [95% CI: 0.75 to 3.58] with an effect size of 0.64, while phase angle rose by 0.52 degrees [95% CI: 0.27 to 0.76], corresponding to an effect size of 0.90. Regarding volumetric estimates, total body water increased by 1.17 L [95% CI: 0.26 to 2.13] with an effect size of 0.54, and intracellular water increased by 0.97 L [95% CI: 0.48 to 1.51] with an effect size of 0.81. No significant differences were observed in extracellular water with change of 0.20 L [95% CI: -0.30 to 0.70] or handgrip strength with an increment of 0.67 kgF, [95% CI: -0.67 to 2.11].<h4>Conclusion</h4>Oral creatine supplementation in HD patients for eight weeks improved muscular and functional outcomes and may be proposed as a strategy to mitigate the elevated morbidity observed in this group of patients.https://doi.org/10.1371/journal.pone.0328757
spellingShingle Waldo Bernales-Delmon
Simón Schulz
Iván Guglielmi
Cynthia Saravia
Yasna Venegas
Jaime Joost
José Aguilar
Andrés Wulf
Paulina Bittner
María Claudia Martínez
Sandy Gómez
Catalina Chávez
Juan John
Felipe Matus
Carla Basualto-Alarcón
Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
PLoS ONE
title Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
title_full Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
title_fullStr Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
title_full_unstemmed Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
title_short Oral creatine in hemodialysis patients increases physical functional capacity and muscle mass, an open label study.
title_sort oral creatine in hemodialysis patients increases physical functional capacity and muscle mass an open label study
url https://doi.org/10.1371/journal.pone.0328757
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