Nephrocalcinosis associated with the use of anabolic steroid

Abstract

Male, 21 years old, admitted with nausea, fatigue, appetite loss, headache and hypertension. Blood tests showed Cr: 3.9 mg% U: 100 mg% and Total Calcium 14 mg/dl. Ultrasonography and renal biopsy were consistent with nephrocalcinosis. There has been gradual improvement in renal function and calcium levels after vigorous hydration and furosemide. However, after 1 year, renal calcium deposits persist, corticomedullary ratio reduced in ultrasound and stable creatinine of 1.4 mg/dl. Previous cases showed acute tubular necrosis and interstitial nephritis with little calcium deposits in the renal interstitium. In this case we found severe nephrocalcinosis associated with nephrosclerosis. Our objective is to report the occurrence of acute kidney Injury with nephrocalcinosis associated with use of anabolic steroid and provide a review of the matter.

Novel Kidney Injury Biomarkers Among Anabolic Androgenic Steroids Users - Evidence of Subclinical Kidney Disease

“…Kidney biopsies from patients who have used anabolic steroids plus vitamin supplements and developed acute kidney injury have shown interstitial nephritis and acute tubular necrosis (8). Renal function monitoring with new biomarkers could be important to detect early and subclinical changes in AAS users and prevent further kidney damage, such as that demonstrated in previous case reports (8,20).…”

“…One of the mechanisms that have been proposed for kidney injury in these cases is the excess use of vitamin D, leading to hypercalcemia, hypercalciuria and nephrocalcinosis (8,20). These patients are at high risk for developing chronic kidney disease and then the early detection of renal damage is crucial to prevent disease progression.…”

Chronic use of steroids and their renal effects

“…The side effects related to the abuse of these substances are the most diverse, ranging from hepatic (Solimini et al, 2017), renal (Luchi et al, 2015;Lewczuck et al, 2019), to behavioral and neurotoxic effects Ribeiro et al, 2019). Among the side effects described in the scientific literature, cardiac side effects are the most commonly related to cases of death, with left ventricular hypertrophy being described in both humans and animals (Shahsavari et al, 2014;Poscidônio et al, 2019;6).…”