Journal Article

Guanidino compounds after creatine supplementation in renal failure patients and their relation to inflammatory status

Youri E. C. Taes, Bart Marescau, An De Vriese, Peter P. De Deyn, Eva Schepers, Raymond Vanholder and Joris R. Delanghe

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 4, pages 1330-1335
Published in print April 2008 | ISSN: 0931-0509
Published online November 2007 | e-ISSN: 1460-2385 | DOI:
Guanidino compounds after creatine supplementation in renal failure patients and their relation to inflammatory status

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Background. Specific guanidino compounds have been described as uraemic toxins and their concentrations are increased in renal failure due to dimished glomerular filtration, whereas the guanidino compound creatine is used as a performance-enhancing substance in athletes. The present study investigates the effects of creatine supplementation on plasma guanidino compounds in a chronic haemodialysis population.

Methods. Twenty male haemodialysis patients were included in a placebo-controlled cross-over trial. Patients were treated with creatine (2 g/day) or placebo during two treatment periods of 4 weeks, separated by a washout of 4 weeks. Plasma guanidino compounds and routine biochemical parameters were determined, as well as the prognostic inflammatory and nutritional index (PINI).

Results. Upon creatine supplementation, guanidinoacetate concentrations decreased by 15%, due to inhibition of creatine synthesis. Concentrations of α-keto-δ-guanidinovaleric acid increased three-fold and argininic acid concentrations doubled. Guanidinosuccinate concentrations did not change, but correlated inversely with CRP (r = −0.736; P = 0.001), PINI-score (r = −0.716; P = 0.002) and correlated positively with plasma urea concentration (r = 0.54; P = 0.02).

Conclusions. Creatine supplementation in haemodialysis patients significantly altered the concentration of specific guanidino compounds. Guanidinosuccinate correlated positively with plasma urea and negatively with inflammation markers.

Keywords: creatine; guanidino compounds; neurotoxins; urea cycle

Journal Article.  2908 words.  Illustrated.

Subjects: Nephrology

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