Complementary bodybuilding: A potential risk for permanent kidney disease

Abstract

We report our experience of renal disease associated with bodybuilders who had been on high-protein diet, anabolic androgenic steroids (AASs), and growth hormone (GH) for years. A total of 22 adult males who volunteered information about use of high protein diet and AAS or GH were seen over a six-year period with renal disease. Kidney biopsy revealed focal segmental glomerulosclerosis (FSGS) in eight, nephroangiosclerosis in four, chronic interstitial nephritis in three, acute interstitial nephritis in two, nephrocalcinosis with chronic interstitial nephritis in two, and single patients with membranous glomerulopathy, crescentic glomerulopathy, and sclerosing glomerulonephritis. Patients with FSGS had a longer duration of exposure, late presentation, and worse prognosis. Those with interstitial disease had shorter exposure time and earlier presentation and had improved or stabilized after discontinuation of their practice. There is a need for health education for athletes and bodybuilders to inform them about the risks of renal disease involved with the use of high-protein diet, AAS, and GH.

miRNAs as Novel Biomarkers of Chronic Kidney Injury in Anabolic-Androgenic Steroid Users: An Experimental Study

“…The tested miRNAs (miRNA hsa-miR-21-5p, miR-205) were overexpressed in both groups tested (AAS and CKD groups) compared to the control. These results could explain what was found by El-Reshaid et al (2018). The chronic use of AAS combined with a high-protein diet can generate severe renal damage such as focal segmental glomerulosclerosis (FSGS), nephroangiosclerosis, chronic interstitial nephritis, and acute interstitial nephritis.…”

Effects of bodybuilding supplements on the kidney: A population-based incidence study of biopsy pathology and clinical characteristics among middle eastern men

“…It does not indicate a significantly increased risk when compared to the FSGS rate of 1.9 (1.3 to 2.5) per 100,000 white males 25-44 years old in Melbourne [31]. The population of Kuwait is similar to Iraqi Kurdistan, and the biopsy frequency of 1.6 cases of FSGS per year among anabolic steroid using bodybuilders reported by El-Reshaid et al [26] would certainly seem excessive, but a relationship to the general incidence of FSGS and the chance of episodic random clustering among bodybuilders must also be considered.…”

“…This cohort consisted of nine patients from New York City (NYC) and one from Boston that was collected over a 10 year period at three major reference centers and presumably reflects the collective experience of nephrologists and pathologists in the region. A similar 2018 paper by El-Reshaid et al [26], reported FSGS among eight "elite" anabolic steroid using bodybuilders from Kuwait that were collected over a period of 5 years.…”

Effects of Bodybuilding Supplements on the Kidney: A Population-Based Incidence Study of Biopsy Pathology and Clinical Characteristics among Middle Eastern Men

“…This cohort consisted of nine patients from New York City (NYC) and one from Boston that was collected over a 10 year period at three major reference centers and presumably reflects the collective experience of nephrologists and pathologists in the region. A similar 2018 paper by El-Reshaid et al [26], reported FSGS among eight "elite" anabolic steroid using bodybuilders from Kuwait that were collected over a period of five years.…”

“…Herlitz et al [8] and El-Reshaid et al [26] is that the NYC and Kuwaiti bodybuilders would be considered steroid dependent, a condition estimated to afflict about 30% of anabolic steroid users but probably not a factor in Kurdistan [27,28]. It is not at all clear whether the FSGS anabolic steroid risk should be based upon all users or only those considered dependent.…”