Mar 03 2010
Long Term Abuse of Steroids May Harm Kidneys Based On a New Study
A recent study on the long term abuse of steroids by bodybuilders was published in the February 2010 issue of Renal and Urology News. The findings may help people understand the effects of steroids if used for longer period of time. The respondents in the study were bodybuilders using anabolic steroids for 8 to 20 years. Researchers said that the kidney is one of the organs that suffer the most when the use of steroids is abused.
Leal Herlitz, MD, an Assistant Professor of Pathology at Columbia University Medical Center in New York headed the research. According to her, athletes who use anabolic steroids and the doctors caring for them need to be aware of the potentially serious risks to the kidney. The group pioneered the study in describing injury to the kidneys following long-term abuse of anabolic steroids.
The study included 10 bodybuilders who were dependent on steroids for many years. Six of them were Caucasians and 4 were Hispanics. These bodybuilders were described as having highly muscular physiques and were using anabolic androgenic steroids between 1999 and 2009. These bodybuilders experienced proteinuria and severe reductions in kidney function.
The findings were presented below:
- respondents had proteinuria of 1g/day or greater
- a renal biopsy diagnosis of focal segmental glomerulosclerosis or FSGS
- the bodybuilders have an average 34.7 kg/m2 BMI which range from 27 to 43
- statistics on men with proteinuria: mean 10.1 g/day, range 1.3- 26.3 g/day
- statistics on the case of renal insufficiency: mean serum creatinine 3.0 mg/dL, range: 1.3- 7.8 mg/dL
- 5 men were diagnosed with full nephritic syndrome.
Focal segmental glomerulosclerosis or FSGS commonly occurs if the kidneys are overworked. This is also common to severely obese people but the group noted that the effects of steroids to the kidneys were more severe. FSGS was diagnosed in 9 patients and 4 of the 9 patients with FSGS had glomerulomegaly at the same time. The researchers conducted biopsies on the respondents and found out that 3 of them had collapsing lesions of FSGS and another 4 had perihilar lesions. There were also 7 bodybuilders who suffered tubular atrophy of 40% or greater and interstitial fibrosis.
Follow up on these bodybuilders were also conducted. The condition of one patient progressed to end-stage renal disease (ESRD) which required dialysis. Most of the respondents received renin-angiotensin system (RAS) blockade while one had received corticosteroid therapy. Seven of the bodybuilders who discontinued the use of anabolic steroids were able to recuperate from the condition. They were also advised to lessen their exercise regimens. Loss of weight was noted but the serum creatinine was stabilized and proteinuria decreased.
The doctors involved in the study concluded that the kidneys are forced to increase their filtration rate when there is an extreme increase in muscle mass. Therefore placing harmful levels of stress on the kidneys. “As in obese patients, the increased strain on the kidney from the elevated body mass leads to hyperfiltration injury,” said Dr. Herlitz. The findings also lead to the assumption that steroids have direct toxic effects on the kidneys. “Numerous animal models have shown adverse effects of androgens on the kidneys and we believe that the anabolic steroids themselves may be directly nephrotoxic,” she added.
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