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

  • Nephrology - Case Report
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

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.

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Acknowledgments

We are grateful to the team of physicians, residents, nurses and medical students of the Hospital Geral de Fortaleza (HGF) for the invaluable assistance provided to the patients and technical support provided for the development of this paper. This research was supported by the Brazilian Research Council (CNPq).

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Authors and Affiliations

  1. Division of Nephrology, Hospital Geral de Fortaleza, Secretaria da Saúde do Estado do Ceará, Fortaleza, CE, Brazil

    Elizabeth F. Daher, Anaiara L. Queiroz, Lysiane M. A. Ramos, Silvia Q. Santos, Dulce M. S. Barreto, Antonio Augusto C. Guimarães & Célio A. Barbosa

  2. Division of Nephrology, Department of Medicine, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, CE, Brazil

    Elizabeth F. Daher & Geraldo B. Silva Júnior

  3. Department of Pathology, School of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil

    Luciano M. Franco & Régia M. S. V. Patrocínio

  4. Rua Vicente Linhares, no. 1198, Fortaleza, CEP 60270-135, CE, Brazil

    Elizabeth F. Daher

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  1. Elizabeth F. Daher
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  2. Geraldo B. Silva Júnior
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  3. Anaiara L. Queiroz
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Correspondence to Elizabeth F. Daher.

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Daher, E.F., Silva Júnior, G.B., Queiroz, A.L. et al. Acute kidney injury due to anabolic steroid and vitamin supplement abuse: report of two cases and a literature review. Int Urol Nephrol 41, 717–723 (2009). https://doi.org/10.1007/s11255-009-9571-8

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  • DOI: https://doi.org/10.1007/s11255-009-9571-8

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