Steroids and Kidney Damage?


The New York Times recently ran a feature titled, “Bodybuilders See Kidney Damage With Steroids.” These stories surface in magazines and newspapers on a regular basis, and many people in the hardcore bodybuilding community are quick to dismiss them as “uninformed, anti-steroid propaganda.” This one however, raised some eyebrows because it not only described the personal plight of several top pro bodybuilders and strongmen whose careers were cut short by kidney disease, it also cited new research that was just published in a top nephrology journal. According to the author, this study was among the first to claim a direct link between long-term steroid use and kidney disease.


If you’ve watched movies like Bigger, Stronger Faster or surfed some of the bodybuilding boards online, no doubt, you’ve heard hardcore bodybuilders defend steroid use. Supporters claim that steroids don’t cause any serious health problems, only relatively minor side effects which can be easily managed.

Perhaps that might be true if these drugs were used in the dosages and durations for which they are prescribed for medical use. Perhaps it might be true if they were used under medical supervision. Perhaps that might be true if users regularly got their bloodwork and health checked. However, that’s not how steroids are being used today at the most elite levels of the game, is it?

Because of their status as controlled substances, steroids are usually purchased on the black market, so the buyer does not always know what he or she is taking. The drugs are self-administered, often at the advice of the dealer or local gym drug guru. Some bodybuilders take them for years. Almost all bodybuilders use multiple drugs. Many are not using drugs, they are abusing them.

With the assistance of chemicals, pro bodybuilders today are continually setting new standards, pushing the envelope on muscle mass, many of them crossing the 300 pounds barrier.

As such, it would be extremely naive to think that steroids are not without more serious risks than mere gyno, acne and testicular shrinkage.

Non-natural bodybuilders don’t just use steroids, they often use a cocktail of drugs including, but certainly not limited to growth hormone, insulin, cytomel, clenbuterol, DNP, and one which perhaps is more responsible for kidney problems than steroids – diuretics.

I am not a doctor or an expert on steroids or performance enhancing drugs. However, I do have theory about why we keep hearing about bodybuilders and kidney problems.

What about the combination of steroids, very high protein diet, unusually high muscular bodyweight, extremely low pre-contest body fat, precontest dehydration and diuretics….could that be a veritable PERFECT STORM for a kidney malfunction or other health problem – even in the absence of genetic predisposition?

Add previous medical history or heredity into the mix and using the standard precontest drug cocktail might be nothing short of playing with matches while doused in gasoline.

How much each one of these factors contributes to the kidney dysfunction, I have no idea, but for those who claim that it was only the high protein or diuretics or genetics might want to know that the new study says there are potential direct nephrotoxic effects of anabolic steroids.

I thought this recent Times story was interesting, and so was the new study, so I wanted to share them with you. The Times story included quotes from bodybuilding luminaries such as Ken “Flex” Wheeler, King Kamali, and Bob Cicherillo. It also featured an interesting video by Patrick Antonecchia, who ended his steroid use and career about a year ago after diagnosis of kidney disease.

Here’s the link, and be sure to check out the video too:

The research paper was published in the Journal of the American Society of Nephrology and was conducted at Columbia University. The abstract of the paper can be read on Pub Med at:

I read the full text of the study. The “Index patient” in the study suffered from focal segmental glomeruloscelrosis, a form of kidney disease. They showed his photo (body) in the journal full text and his physique was clearly that of a pro competitor (nearly 300 lbs). His profile was as follows:

  • 30 years old, male caucasian
  • 6 feet 1 inch tall, 295 pounds
  • Professional bodybuilder
  • consumed 550 grams of protein per day
  • supplements: creatine, glutamine, BCAA, multivitamins
  • drugs: injectable testosterone, oral methyl-1 test, GH, insulin & ephedrine/caffeine
  • Anabolic steroid use for 10 years
  • blood pressure at time of first hospital check in: 145/80
  • patient put on medication and told to desist from bodybuilding
  • 2 months after quitting bodybuilding, lost 40 pounds. 8 months later lost another 40 lbs – (215 lbs)
  • blood pressure dropped to 110/75, renal health improved, but he suffered from severe depression related to changes in body image (perceived himself as “skinny and weak”)
  • Patient resumed training and high protein diet, drug free, weight climbed to 267 lbs
  • Against dr’s orders, patient resumed drugs and climbed to 296
  • Patient had relapse of kidney problems, leading doctors to propose a form of focal segmental glomeruloscelerosis (kidney disease) was directly a result of steroid use combined with the unusually high lean body mass/body mass index
  • (no mention of diuretics)

Some people might figure, yeah, this is just a rare case study – and it was in fact just a case study. But there were 10 subjects in the cohort and it was published in a peer-reviewed journal.

Most of us in bodybuilding have heard “locker room talk” about kidney problems and drug-using competitive bodybuilders for decades. More anecdote, Yes I know. But I haven’t just read about this. I’ve seen it.

A friend of mine, earlier this year, was forced to end his bodybuilding career after he was rushed to the hospital – on the day before his contest – with kidney failure. Thank God he recovered without permanent damage. But his doctor, who said she had seen many bodybuilders in her emergency room before, told him he had to quit the steroids… And competition. Forever.

It hits you quite a bit harder when it happens to someone you’ve known for years – someone who had no known genetic predisposition for kidney trouble, no medical history and who claimed to be very careful about his usage. He was also under 200 pounds.What does it take for the bodybuilding community to start to rethink this?

Train hard, train natural,
Tom Venuto, author of
Burn The Fat, Feed The Muscle

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Comments on Steroids and Kidney Damage? Leave a Comment

December 16, 2009

Lee @ 1:40 am #

I think it’s going to be a hard one to tackle, Tom, as people who are competitive by nature will stay competitive, as we can see when even they are faced with disease.
It’s similar to the battle to get people, who in general are sedentary, to get moving – this goes against their nature, something acquired through tens of thousands of years of being as caloric efficient as possible.
I could see potential in educating young people – perhaps presentations from these diseased bodybuilders themselves – in attempt to stop the interest in taking the sport to an extreme in the first place.

Maciej @ 1:59 am #

The saddest part for me is the fact that the poor fella felt “skinny and weak”, and was probably still in better shape than 99% of the population. Anyway, where’s the common sense? It doesn’t matter whether you’re anorexic or hardcore bodybuilder, if you’re putting yourself on the totally extreme side of anything – doesn’t that just ring a bell in your head “Hey, I look awesome, but I’m obsessed with steroids and eating protein and that’s not exactly what human body was designed to do, so perhaps it will cause some serious health problems in the long term?”.
Another problem is the motivation to doing dangerous things/crimes/risky behaviours etc. is always the same. Although everybody knows that “it will cause damage to some % of prople who do that” each and every person thinks that “well, it won’t happen to me”. It really doesn’t matter if the kidney problems are highlighted and will become widely known fact about steroid abuse/use, there will always be guys with the Arnold/Ronnie/Jay image stuck in their mind and will do anything to pursue their goal.
So the bottom line is – majority of drug users just doesn’t care, but perhaps spreading the word will help some of the smarter ones to stop or not to start, good article as usual, Tom!

Craig @ 9:19 am #

Am I right in thinking that, in in non-natural body building, steroid use is not actually legal (as it’s illegal to use steroids without a prescription for a medical condition) but the governing bodies tend to turn a blind eye to their use. They have the right to test competitors whenever they choose, but almost never do.
If this is the case, it seems the solution is simple. All competitive body building, if viewed in the same way as other sports, should be free from performance (or mass) enhancing drugs. Have the same testing procedures as used in other sports, test all competitors who “place” in a contest, and have regular random tests on all registered members of body building associations.
With this in place, most competitive body builders will clean up their act as the risk of getting caught and receiving a ban will simply be too high.
Yes, there will still be body builders who take drugs, and, as in other sports, some of these may slip through the net from time to time, but on the whole body building will be an infinitely cleaner sport.
Furthermore, once competing clean becomes the norm, as in athletics, competitors who use drugs will find themselves shunned by their peers.
Body building can be clean, but it will start with a change in attitude from the governing bodies.

Marc David @ 12:38 pm #

Much like the War on Drugs … articles and studies showing the damage will have little to no effect. The population that would EVEN considering taking them is not open to ideas from peer reviewed journals or stories like these where they think “it can’t happen to me.”
* War on Drugs
* Scared Straight
* Just Say No
* Take a Bite Out of Crime
All fine campaigns but overall, make little difference for the big picture.
Possible Ideas to Lessen the Impact:
Provide education at the source –>
* Good parenting and active parents that take notice of any drug abuse in their childs life. Nature vs. Nurture but parents who are involved, stand a better chance at spotting a problem.
* Gym Education (public schools; public gyms). Assuming there are still gym classes, it’s a subject where we KNOW kids are aware of steroids and yet it’s never broached in well educated manner. It’s just another “Drugs are bad, muh-kay.”
Steroids are just like any other drug. A problem that has several ideas and no single easy to implement solution.
What makes it slightly worse is that steroids are acceptable in major bodybuilding competitions. In fact, if you have a dream to compete in such competitions, you’ve got to be on the same playing field.
Different than professional sports where it’s tested for but we know some people (maybe a lot) get away with it. Yet we still want to believe most do not.
Until that changes .. Acceptable Behavior … I don’t see how the world of bodybuilding will ever get rid of the problem.
The key being.. Acceptable. Well known, and swept under the rug. If that doesn’t change, I predict we’ll just see more of these studies and more over the hill bodybuilders come out and speak about the evils of steroid use (when they took them and would probably do it again anyway).

tom venuto @ 12:56 pm #

craig, steroids are not only illegal without prescription, they are a controlled substance at this point, treated the same legally as cocaine, etc.
All the mainstream sports ban performance enhancing drugs as does the olympics, which arguably tries the hardest in its testing.
Pro bodybuilding and powerlifting are two sports where there are tested (natural) and untested (drugs used) divisions.
This may sound strange to you, but if a level playing field is the goal, then perhaps bodybuilding and powerlifting are the only sports who have it right – at least in one sense – the fairness aspect: if you use, you compete in the open organizations, if you dont use, you compete in the natural organizations
Yes you could say the pro bb organizations turn a blind eye to drug use, but the drugs are not banned and it is widely accepted in that segment of bodybuilding culture that virtually 100% of the athletes use them. yes 100% at that level (lets call it 99% to be fair).
So in that sense, there IS a level playing field and the level playing field and integrity in sports and integrity among the athletes (not lying about usage) is one of the most important issues in the steroid debate.
But in baseball, for example, if we had two divisions – an all-drug league and a drug tested league – that would be considered so ridiculous it could (and HAS been) fodder for late night talk show or saturday night live jokes.
When there is only ONE division and its drug tested, then things are clear – drug use is cheating and its wrong. End of discussion. To say ‘its not cheating if everyone is using’ is a Bullsh*t excuse. Its immoral, its cheating and its infringing on others who dont use if its against the rules.
health is another discussion than legality or morality.
But they are related because even if you’re on a level playing field, if there is no drug testing, then as the standards for mass keep going up and the limits of human development continue to get stretched with the assistance of artificial enhancements, I predict we are going to continue to see more and more reports of serious health problems like kidney disease surfacing.
I think as the years pass and many baby boomer bodybuilding and strength athletes enter mid life, the consequences of long term use will also begin to surface more and more.

Craig @ 1:45 pm #

Tom, I see your point that in body building there is, or rather there are two, level playing fields; one where competitors are ‘clean’ like yourself, and one where drugs are the norm.
I agree that this could be the case in other – almost any – sport. In everything from athletics to darts (betablockers may well assist stress and even help throw between heartbeats) there could be two codes.
From a health perspective however (I won’t start on the health of darts players!) I would think that is is the duty of governing bodies to protect the competitors as far as possible when they take part in a given sport.
No sport is without risk, but these risks are usually inherent in the sport rather than being caused by abusing one’s body to enhance performance. Even boxing has made leaps in protecting its competitors since the high-profile brain injuries of Michael Watson and Gerald McClellan.
I don’t believe that pro body building will ever be clean while drug use is legal in the sport, for the simple reason that it is almost impossible to win an ‘open’ competition without using drugs.
I’m also with you when you say that standards will continue to rise and mass levels will continue to increase, among natural body builders as well as non-natural. Just as world records continue to be broken in athletics and similar sports, standards will rise where the sport is judged.
On a separate note, there were arguments in some of the articles that you linked to that suggested steroids may not be the (sole) cause of the kidney damage seen in pro body builders. Other factors may be the high muscle mass, low body fat, high protein diet, use of creatine, and dehydration for competition. If this is the case wouldn’t we have seen similar conditions among the natural competitors such as yourself, notwithstanding the (generally) lower muscle mass?

Jake Sherbrooke @ 2:53 pm #

A quote from BFS, “[Out of all the people who take steroids, the fact is, x amount will suffer the harsh side effects]” It is a risk taken, knowingly, by those of us who choose to participate. Nobody is sticking anything in ourselves, but ourselves. I am sure if the % rate started to climb, the more people would rethink, but the fact remains is its that x % that suffer and the majority are fine. Now this doesn’t mean that we should ignore this percentage, after all they are people, just like you and I and they share the same passion we all do and certainly we must not sit back and say “sorry bro, its gotta happen to someone.” I really believe this “pushing the limit,” in bodybuilding will eventually be its downfall. I was happy to see an earlier article on the return of “Classic Bodybuilding,” guys weighing 200 and less, still big, still jacked, but not looking like the new hollywood Hulk. It was “is” about symmetry, proportion, muscularity. Not overall how big you are! A lot of changes need to taken and precautions to reverse this trend in BB that I believe can really help lower some of these tragic articles of our fellow brethren that we continue to get fed by the news. May bodybuilding and steroids live on! but only if we take a step back and look at what were really creating.

Tom Venuto @ 3:08 pm #

re: responsibility of the bodybuilding organizations. I would agree, but in the case of this “subculture”/ sport of open bodybuilding, I suspect that enforcement of drug testing would be the demise of that side of the sport, don’t you? On one hand, the audience wants to see freaks. on the other hand, its tough for any sport to go backwards in its standards of performance. the forces that be are pushing for things to stay the way they are until and unless something really bad happens.
Also, if the open divisions test, lots of folks are still going to use, and there goes our level playing field, because other folks will never use.
It would probably do more good for the organizations to change their judging criteria to reward the more symmetrical physiques, but that’s tough as well, because bodybuilding is about size too and a big symmetrical physique should beat a smaller symmetrical phsysique.
I think it will for naturals to keep raising the bar in their divisions and get public about showing just how fine a physique can be built without drugs. I think this will bring more into and keep more in the natural side
Im somewhat glad there are open untested organizations and separate natural, tested organizations because I feel that this way the natural organizations really are closer to being clean. If there were only tested contests, in which case there would be more cheaters.
Re: re cause of the kidney problems. from the evidence Ive seen, Im not sure if steroids can be solely implicated. As I mentioned, i think there is a “perfect storm” effect of multiple factors converging, which could give some clues on how bodybuilders can reduce the risks of this happening to them.
In the new research paper I read, the doctors gave a LOT of credence to the huge body mass – even lean body mass – as a contributing factor along with long term steroid use.
When you consider that an amateur natural bodybuilder my height weights on stage as a middle at 176 lbs and the assisted pro bodybuilder could weigh 276 at the same height I think thats a clue.
naturals also do some pretty high protein intakes and sometimes use dehydration tactics before shows, albeit not with prescription diuretics. Im sure that puts some stress on the body, but i have a hard time believing the risk is the same for a natural.
It was my own theory that the diuretics and final stage of contest prep adds to that “perfect storm”, effect as these last minute or day of contest hospitalizations are something I have seen over and over among steroid and diuretic using bodybuilders, but i havent seen it in naturals who were otherwise healthy.

February 22, 2010

Johnny G @ 7:34 pm #

years ago a natural bodybuilder weighed about 15lbs to 30lbs more then the average man, now the drug induced bodybuilder has 100 lbs more then the average man – INSANE

April 5, 2010

I read about this study and wrote about it on my blog a while back. I think we are dealing with guys who were doing pretty serious dosages.
Average BMI was 34.7.
34.7 BMI for a 5’10” man is around 240 lbs; Arnold Schwarzenegger is 6’2″ and competed at a weight of 220 lb.

May 25, 2010

John @ 9:18 am #

I heard about many side effects from steroids. I’m not sure if I heard about kidney failures. Seems that this list of negative effects is growing and growing.
I understand that “skinny and weak” guy. That he felt bad about his body but when we stop caring about balance, it can hurt a lot more. The pleasure of big muscles is greater than pain from damaged health.

January 5, 2011

Derek @ 9:24 pm #

I think competition is high and people will do what they do, no matter what the consequences. People still smoke, even though they know it is going to give them cancer. Why wouldn’t muscle-heads keep doing roids?

March 5, 2011

Methylone @ 5:06 pm #

It would be one thing to dismiss the kidney damage stories if they did not have scientific backing to prove that is the cause for said damage. The effects have been scientifically noted atleast 10 times were sole kidney damage was from steroid usage

April 1, 2011

Scary when you read about a bodybuilder who stops taking steroids, his body balances itself, and then he resumes taking steroids and his body starts turning on him again. Stay natural!

April 6, 2011

I can only say BE STRONG – BE NATURAL what has been my “thing” from day one when i liftet my first weight at the year of 28, until now at 45 year, where I am proud to say that my best year was 2010, where i did look my best ever at the WNBF natural univers.
WNBF is not only drugtesting all the athletes, but all are need to pass the polygraph test.
Great work Tom.
BESTRONG regards Henning Kristensen 100% natural athlete.

September 4, 2011

Jill @ 6:55 pm #

No competition is worth sacrificing your health for. Body building, practised properly, is great to get into, but you have to be sensible about it. Using drugs to help you gain unnatural muscle is cheating in my eyes anyway. I’d sooner be the best I can be naturally and know I’m doing my body a favour by keeping it healthy, not destroying it by abusing it. You don’t have to win the competition to be a winner. I’m sure a lot of people will not understand that statement, but it’s true.

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