The For Kidneys Sake podcast series is brought to you by Imperial College Healthcare NHS Trust and North West London Integrated Care Board (NWL NHS)

The For Kidneys Sake podcast series, returns with refreshed episodes from our earlier series. With over 30 episodes and 15,000 listeners, we’re revisiting key topics while we prepare our next series.

In this episode, Prof Jeremy Levy and Dr Andrew Frankel explore a common and often overlooked clinical question: what impact do supplements, herbal remedies, and recreational drugs have on people with chronic kidney disease (CKD)?

From creatine and high-dose vitamins to anabolic steroids, ketamine, and traditional herbal medicines, this episode challenges the assumption that “natural” means safe. The discussion highlights the importance of asking patients directly about non-prescribed products and explains how some substances can either harm the kidneys or confuse clinical assessment. The core message remains unchanged: creatine is not nephrotoxic but can affect creatinine readings, herbal remedies may be harmful and should be avoided, and high-dose vitamin C and inappropriate vitamin D use can pose risks in CKD.

Key Takeaways

Ask directly about supplements, herbal remedies, and recreational drugs, they are often missed

Standard multivitamins are generally safe, but high-dose vitamin C and vitamin D can be harmful

Creatine can raise creatinine and lower eGFR without indicating kidney disease

Anabolic steroids and ketamine carry serious kidney and bladder risks

Herbal remedies may be nephrotoxic or interact with medications and should be avoided in CKD

Use a full assessment (ACR, urine dipstick, BP, imaging), not creatinine alone

References:

Creatine and kidneys: Nutrients 2023, 15, 1466. doi.org/10.3390/nu15061466

Herbal medicines and CKD; Nephrology 15 (2010) 10–17 doi:10.1111/j.1440-1797.2010.01305.x

Herbs and more: Drug stewardship for people with chronic kidney disease; towards effective, safe, and sustainable use of medications: Nat Rev Nephrol. 2024 June ; 20(6): 386–401. doi:10.1038/s41581-024-00823-3

Resource Links:
NICE GUIDELINES [NG203] chronic kidney disease: assessment and management Overview | Chronic kidney disease: assessment and management | Guidance | NICE

Northwest London CKD guidelines for primary care

The purpose of this podcast is to inform and educate health care professionals working in the primary care and community setting. The content is evidence based and consistent with NICE guidelines and North West Guidelines available at the time of publication.

The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement.

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