數篇個案報告顯示，肌酸增補後發生橫紋肌溶解症、腔室症候群及急性腎衰竭等腎損傷的狀況，故本文就肌酸的安全性、運動導致橫紋肌溶解症合併急性腎衰竭的成因及肌酸增補造成腎臟損傷可能機轉進行探討。經彙整相關文獻後發現肌酸增補且搭配高強度訓練時，可增加訓練量、並提高下肢前腔室壓力，而增加腎損傷的風險。而多數研究結果仍支持肌酸為安全的運動營養增補劑，建議安全的增補方式為每天 20公克、持續 5天的負荷期後，接著為每天 3-5公克、持續時間不超過 30天的維持期，且使用前須注意有無腎臟疾病史病及避免過度運動訓練而導致急性腎衰竭。

Some case reports have revealed that creatine supplementation lead to rhabdomyolysis, compartment syndrome, and acute renal failure (ARF). This paper reviewed the safety of creatine supplementation, the causes of exercise leading to ARF due to rhabdomyolysis and the mechanisms of creatine supplementation resulting in kidney dysfunction. This article summarized that creatine supplementation with strenuous exercise will increase the risks of kidney dysfunction. The major reasons are the training volume and anterior compartment pressure increasing under this situation. However, most of the studies supported that creatine is a safe nutritional ergogenic aid. The recommendation for safe use is consuming a loading phase with 20 g per day for 5 days and subsequently a maintenance phase with 3-5 g per day for less than 30 days. Moreover, consumers should notice his history of kidney disease and avoid overtraining when taking creatine.