When Bodybuilding Goes Wrong—Bilateral Renal Artery Thrombosis in a Long-Term Misuser of Anabolic Steroids Treated with AngioJet Rheolytic Thrombectomy

Artur Lemiński, Markiian Kubis, Krystian Kaczmarek, Adam Gołąb, Arkadiusz Kazimierczak, Katarzyna Kotfis and Marcin Słojewski
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Artur Lemiński: Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Markiian Kubis: Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Krystian Kaczmarek: Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Adam Gołąb: Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Arkadiusz Kazimierczak: Department of Vascular Surgery and Angiology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Katarzyna Kotfis: Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
Marcin Słojewski: Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland

IJERPH, 2022, vol. 19, issue 4, 1-6

Abstract: Bilateral renal infarction is an extremely rare condition with only few cases reported in the literature. We present a case of bilateral renal infarction affecting an otherwise healthy 34 year old bodybuilder chronically misusing testosterone and stanozolol. The patient presented with severe flank pain mimicking renal colic and biochemical features of acute kidney injury. Diagnostic workup revealed thrombosis affecting both renal arteries. Subsequently, the patient underwent a percutaneous rheolytic thrombectomy with AngioJet catheter, along with catheter-directed thrombolysis. Right-sided retroperitoneal hematoma developed as an early complication, mandating surgical exploration and nephrectomy due to kidney rupture and the unstable condition of the patient. Intensive care and continuous renal replacement therapy were instigated until a gradual improvement of the patient status and a return of kidney function was achieved. No abnormalities were found in the cardiological and hematological evaluation. We believe this is a first report of bilateral renal infarction associated with anabolic steroid misuse in an otherwise healthy individual, and a first report of AngioJet thrombectomy in bilateral thrombosis of renal arteries. It stresses the importance of a thorough diagnostic workup of colic patients and emphasizes the need for sports medicine to reach out to amateur athletes with education on the harms of doping.

Keywords: doping in sports; public health; testosterone; stanozolol; thrombosis; renal infarction; acute kidney injury; thrombolytic therapy; nephrectomy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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