Assessment of Renal Function of Bodybuilders Using Anabolic Androgenic Steroids and Diet Supplements

Sultan Ozkurt; Engin Ozakin; Hilal Gungor; Ahmet Ugur Yalcin

doi:10.7759/cureus.43058

Assessment of Renal Function of Bodybuilders Using Anabolic Androgenic Steroids and Diet Supplements

Cureus. 2023 Aug 7;15(8):e43058. doi: 10.7759/cureus.43058. eCollection 2023 Aug.

Authors

Sultan Ozkurt¹, Engin Ozakin², Hilal Gungor³, Ahmet Ugur Yalcin¹

Affiliations

¹ Nephrology, Faculty of Medicine, Eskişehir Osmangazi Üniversitesi, Eskişehir, TUR.
² Emergency Medicine, Faculty of Medicine, Eskişehir Osmangazi Üniversitesi, Eskişehir, TUR.
³ Internal Medicine, Eskişehir City Hospital, Eskişehir, TUR.

Abstract

Introduction Anabolic androgenic steroids (AAS) and diet supplements (DS) are frequently used by bodybuilders. In this specific group, increased muscle mass, the acute effects of exercise, and the use of creatine may affect the creatinine-based estimated glomerular filtration rate (eGFRcr), potentially leading to an underestimation of the GFR. Cystatin C equations offer a more accurate prediction of GFR that is independent of muscle mass. We aimed to assess the renal functions of bodybuilders who use both AAS+DS, as well as those who only use DS, by calculating the GFR based on cystatin C (eGFRcys) and also using a combination of cystatin C and creatinine (eGFRcys/cr). Methods The study included 12 bodybuilders using AAS+DS and 12 bodybuilders using DS. In both groups, serum cystatin C levels, eGFRcys, eGFRcys/cr, urine albumin excretion rates, urine protein excretion rates, and routine tests were examined. Results In AAS+DS users, the average duration of AAS use was 3.08±2.02 years, while for DS users, the duration of supplement use was 3.67±2.49 years. The spot urine albumin/creatinine and protein/creatinine ratios were higher in AAS+DS users (p<0.001 and p=0.006, respectively). Although eGFRcr was found to be similar in the AAS+DS and DS groups (119.67 ± 24.12 ml/min and 122.08 ± 18.03 ml/min, respectively; p=0.426), eGFRcys and the eGFRcys/cr ratio were significantly lower in the AAS+DS group compared to the DS group (eGFRcys: 120.67 ± 19.48 ml/min vs. 122.08 ± 18.03 ml/min, p=0.039; eGFRcys/cr: 121.83 ± 20.62 ml/min vs. 126.33 ± 21.163 ml/min, p= 0.036, respectively). Conclusion Cystatin-based GFR values were found to be significantly lower in AAS+DS users, and urinary albumin and protein excretion were considerably higher compared to DS users. Although these findings suggest a potential link between early kidney damage and the direct use of AAS, the topic requires further investigation.

Keywords: anabolic androgenic steroids; bodybuilders; diet supplements; glomerular filtration rate; renal side effects.