Acute kidney injury due to anabolic steroid and vitamin supplement abuse: report of two cases and a literature review

Abstract

AKI is an important complication of anabolic steroid and vitamin supplement abuse. The exact pathophysiology of this type of AKI remains unclear. The main cause of renal dysfunction in these cases seems to be the vitamin D intoxication and drug-induced interstitial nephritis. It is mandatory to start early treatment for serious hypercalcemia, with vigorous venous hydration, diuretics and corticosteroids.

Novel Kidney Injury Biomarkers Among Anabolic Androgenic Steroids Users - Evidence of Subclinical Kidney Disease

“…Kidney disease has been reported among AAS users, but only in individuals with significant kidney damage (3,8). The discovery of novel biomarkers has a great importance for early detection of kidney disease and allows the adoption of measures to prevent or slow kidney disease progression.…”

“…The levels of the new biomarker MCP-1 were significantly higher among AAS users in our study, suggesting subclinical renal inflammation, which can be directly caused by AAS use, including the possibility of chronic interstitial nephritis. Kidney biopsies from patients who have used anabolic steroids plus vitamin supplements and developed acute kidney injury have shown interstitial nephritis and acute tubular necrosis (8). Renal function monitoring with new biomarkers could be important to detect early and subclinical changes in AAS users and prevent further kidney damage, such as that demonstrated in previous case reports (8,20).…”

“…Renal function abnormalities are described among AAS users, usually when supra-physiologic doses are used, including the use of veterinary supplements (3,8). One of the mechanisms that have been proposed for kidney injury in these cases is the excess use of vitamin D, leading to hypercalcemia, hypercalciuria and nephrocalcinosis (8,20).…”

“…One of the mechanisms that have been proposed for kidney injury in these cases is the excess use of vitamin D, leading to hypercalcemia, hypercalciuria and nephrocalcinosis (8,20). These patients are at high risk for developing chronic kidney disease and then the early detection of renal damage is crucial to prevent disease progression.…”

“…Past studies suggest an increased risk of developing chronic kidney disease among AAS users, and it can be asymptomatic for a long time before diagnosis (7,8). In recent years several studies have been conducted to early identify kidney diseases through the use of new biomarkers (9-11), but it has not been yet investigated in the setting of AAS use.…”