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

Abstract:

BACKGROUND:The use of anabolic steroids and vitamin supplements has reached alarming proportions in the last decades. Adverse effects have been documented and include virilization, feminization, adverse lipid profile, psychiatric disorders, cardiac and liver disease. Acute kidney injury (AKI) is not frequently described. The purpose of this study is to report two cases of AKI associated with anabolic steroid and vitamin supplement abuse. CASE REPORT:Two men, aged 21 and 30 years, presented to the Emergency Department with abdominal pain, nausea and vomiting. They reported the use of anabolic steroids and veterinary supplements with vitamins A, D and E. Laboratory tests showed AKI (serum urea 79 and 52 mg/dl, serum creatinine 3.9 and 1.9 mg/dl) and hypercalcemia (calcium 13.2 and 11 mEq/l). Kidney biopsies showed inflammatory interstitial nephritis and acute tubular necrosis. Treatment consisted of vigorous hydration with simultaneous use of furosemide and discontinuation of the vitamins and anabolic substances, and resulted in recovery of renal function. CONCLUSIONS: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.

journal_name

Int Urol Nephrol

authors

Daher EF,Silva Júnior GB,Queiroz AL,Ramos LM,Santos SQ,Barreto DM,Guimarães AA,Barbosa CA,Franco LM,Patrocínio RM

doi

10.1007/s11255-009-9571-8

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

717-23

issue

3

eissn

0301-1623

issn

1573-2584

journal_volume

41

pub_type

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