Nutritional and Non-Nutritional Strategies in Bodybuilding: Impact on Kidney Function

Abstract

Bodybuilders routinely engage in many dietary and other practices purported to be harmful to kidney health. The development of acute kidney injury, focal segmental glomerular sclerosis (FSGS) and nephrocalcinosis may be particular risks. There is little evidence that high-protein diets and moderate creatine supplementation pose risks to individuals with normal kidney function though long-term high protein intake in those with underlying impairment of kidney function is inadvisable. The links between anabolic androgenic steroid use and FSGS are stronger, and there are undoubted dangers of nephrocalcinosis in those taking high doses of vitamins A, D and E. Dehydrating practices, including diuretic misuse, and NSAID use also carry potential risks. It is difficult to predict the effects of multiple practices carried out in concert. Investigations into subclinical kidney damage associated with these practices have rarely been undertaken. Future research is warranted to identify the clinical and subclinical harm associated with individual practices and combinations to enable appropriate and timely advice.

Keywords: androgenic steroids; bodybuilding; hypervitaminosis; kidney function; nutritional supplements.

Figure 1

Flow diagram describing the search methodology used to obtain the research studies for this review.

Figure 2

Determinants of serum creatinine.

Figure 3

Possible mechanisms and pathophysiology of kidney injury due to exposure to AAS and intramuscular vitamins A, D and E. ADE = intramuscular vitamins A, D and E. AAS = anabolic androgenic steroids. RAAS = renin–angiotensin–aldosterone system. FSGS = focal segmental glomerulosclerosis. CKD = chronic kidney disease. AKI = acute kidney injury. + = increased effect.