Kidney disease associated with androgenic-anabolic steroids and vitamin supplements abuse: Be aware! / Sérgio Luiz Arruda Parente Filhoa, Pedro Eduardo Andrade de Carvalho Gomes, Guilherme Aguiar Forte, Laio Ladislau Lopes Lima, Geraldo Bezerra da Silva Júnior, Gdayllon Cavalcante Meneses, Alice Maria Costa Martins, Elizabeth De Francesco Daher. - (Nefrología (2019) 1 October; p. 1-6)

• PMID: 31585781.
• DOI: 10.1016/j.nefro.2019.06.003

Abstract

The excessive chase for beauty standards and the rise of muscle dysmorphia have ultimately led to an increase in androgenic–anabolic steroids (AAS) and intramuscular injections of vitamins A, D and E (ADE) abuse, which is associated with several adverse effects and has become a public health issue. This review of literature discusses kidney injury associated with the use of AAS and ADE, highlighting the mechanisms of acute and chronic renal lesion, such as direct renal toxicity, glomerular hyperfiltration and hypercalcemia. Future perspectives regarding evaluation and early diagnosis of kidney injury in these patients are also discussed.

On July 8, 2010, the Royal Dutch Baseball and Softball Federation (Koninklijke Nederlandse Baseball en Softball Bond, KNBSB) Disciplinary Committee decided to impose a 2 year period of ineligibility on the person after his sample tested positive for the prohibited substance methylhexaneamine (dimethylpentylamine)

Person stated in his defence that he had used a supplement with the prohibited ingredient geranamine (methylhexaneamine), but didn’t know it was since 2009 on the prohibited list.
In September 2010 WADA published the 2011 prohibited list. The status of 4-methyl-2-hexanamine (methylhexaneamine) changed to ‘specified substance’. This status change was made after request of a number of anti-doping authorities, including the Dutch Anti Doping Authority, because free available supplements contain this substance.
This status change gives the committee the possibility to reduce the sanction due to the lex mitior. On 12 October 2010 the committee already lifted person’s ineligibility and on 8 February 2011 the KNBSB Appeal Committee decides to reduce the period of ineligibility until 12 October 2011. Fees and expenses for this Appeal Committee shall be borne by sport club.

On 6 July 2011 the Koninklijke Nederlandse Baseball en Softball Bond (KNBSB), the Royal Dutch Baseball and Softball Federation, decided to impose a 9 month period of ineligibility on the Athlete after his sample tested positive for the prohibited substance cannabis.

Hereafter the Athlete appealed the KNBSB decision of 6 July 2011.
The Athlete did not dispute the positive test or the anti-doping rule violation. The Athlete invoked the principle of proportionality due to the imposed sanction is too severe. In Addition the Dopingautoriteit, Anti-Doping Authority the Netherlands, provided information to the KNBSB to determine the sanction related to cannabis anti-doping rule violations in the Netherlands.

The Appeal Committee concludes that the imposed sanction was disproportional. Therefore the KNBSB Appeal Commission decides to set aside the decision of the KNBSB Disciplinary Committee of 6 July 2011 and to impose a reprimand on the Athlete.

The Koninklijke Nederlandse Baseball en Softball Bond (KNBSB), the Royal Dutch Baseball and Softball Federation, has reported an anti-doping rule violation against the Athlete after his sample tested positive for the prohibited substance cannabis.

At the hearing the Athlete admitted the use of cannabis. Without intention to enhance sport performance the KNBSB Disciplinary Committee decides to impose a 9 month period of ineligibility, starting on 1 July 2011.

Facts
On 6 July 2011 the Royal Dutch Baseball and Softball Federation (Koninklijke Nederlandse Baseball en Softball Bond, KNBSB) charged the athlete for a violation of the Anti-Doping rules. After a match in 2011 a sample was collected for doping control purposes. Analysis of the sample showed the presence of formoterol.

History
The respondent had mentioned the use of medication on the doping control form. Although there was no dispensation for the use of this medication the panel considers that it wasn't used to enhance sport performance.

Decision
The sanction is a reprimand.

Related case:
ISR 2005 KNCB Decision Disciplinary Committee 2005072 T
November 24, 2005

Defendant appeals against the decision of the Disciplinary Committee of the Royal Netherlands Cricket Association (Koninklijke Nederlandse Cricket Bond, KNCB) dated November 24, 2005.

Defendant presents a written defence and attends the oral hearing on March 22, 2006.
Defendant argues:
There is a violation of the rights for a fair trial: he should have been notified that he was entitled to ask copies of the lab-tests. But the KNCB did notify him by letter.
Lack of (convincing) evidence: defendant claims that the opinion of the disciplinary committee that the results of the lab can be missed. The appeal committee doesn't agree because the defendant didn't ask for a B-sample analyses. Defendant didn't ask for copies although he was informed to do so. A derivation of the international standard for laboratories was mentioned by the defendant but the appeal commission doesn't regard this as a reproach.
The appeal commission is not aware of any circumstances in which his confession is not considered to be valid.
The detected substances don't enhance sport performance: the appeal commission concludes it doesn't matter if a substance enhances sport performance, the fact that it is a prohibited substance is the violation.
Conflict with equality of principles: The defendant claims equality of principles for his recreational use of a narcotic, the appeal commission disagrees because cannabinoids are on the prohibited list.
Penalty: The defendant also claims the period of ineligibility is too long, his council mentions the principle of proportionality. Only when the defendant can prove his that there is no significant fault or Negligence the period of ineligibility can be reduced. The appeal committee sees no regulations for recreational use of drugs.

The appeal commission considers: not having the intention of enhancing sport performance; the drug was used social / recreational; there is no regular use; no prior disciplinary convictions; the athlete is not a professional in cricket

The appeal commission decides that the penalty will be reduced. The two years of ineligibility will be partly conditional (for 12 months) with a test period of 2 years commencing on the date of his last game.

In June 2011 the Koninklijke Nederlandse Cricket Bond (KNCB), the Royal Netherlands Cricket Association, has reported an anti-doping rule violation against the Athlete after his sample tested positive for the prohibited substance cannabis.
After notification the Athlete filed a statement in his defence and was heard for the KNCB Disciplinary Committee. The Athlete admitted he used cannabis out of competition a week before the doping test during the festivities on 30 April 2011.

Considering the Athlete had no intention to enhance his sport performance the KNCB Disciplinary Committee decides to impose a 6 month period on the Athlete starting on the date of the decision.
Fees and expenses for this committee shall be borne by the Athlete.

Facts
The athlete had appealed against the decision of the disciplinary committee of the Royal Netherlands Cricket Association (Koninklijke Nederlandse Cricket Bond, KNCB), of November 20, 2013. till June 17, 2014.

History
The athlete had been sanctioned with a period of ineligibility of two years, because of a positive on the prohibited substance ecstasy (MDMA) and cocaine. However the athlete was at that time in difficult personal circumstances because of his deceased mother after a long period of sickness. For this he pleads a reduction of the sanction on personal grounds.
The panel takes in consideration that the concentration of the found drugs was low. The president of the Anti-doping Authority Netherlands confirms that there is no hard evidence that these drugs enhanced his sport performance. His sad family matter and being his first violation makes a reduction of the sanction possible.

Decision
1. The sanction is a period of ineligibility of one year, starting from June 18, 2013.
2. The earlier decision of the disciplinary committee of the KNCB is cancelled.

Facts
The disciplinary committee of the Royal Netherlands Cricket Association (Koninklijke Nederlandse Cricket Bond, KNCB), charged the player for a violation of the Anti-Doping rules. During a match in 2013 the player provided a sample for doping test purposes. Analysis of the sample showed the presence of cocaine. Cocaine is a prohibited substance according the World Anti-Doping Agency prohibited list.

History
The player had used the prohibited substance during a party in a social setting, he didn't had the intention to enhance his sport performance.

Decision
The sanction is a period of ineligibility of two years in which the player can't take part in competition or manifestations organized or authorized by the KNCB.

In October 2017 the Royal Netherlands Cricket Association (KNCB) has reported an anti-doping rule violation against the Person after his sample tested positive for the prohibited substance Cannabis in a concentration above the WADA threshold (180 ng/ml). After notification the Person filed a statement in his defence and he did not attend the hearing of the KNCB Disciplinary Committee.

The managers of the cricket team stated that the Person plays cricket occasionally nor did he train regularly. They knew that he used Cannabis out-of-competition and he was called to play only the day before the competition.

The Committee acceps that the Person used Cannabis out-of-competition in a context unrelated to sports performance. He plays cricket occasionally and usually he is called on short notice when the cricket team is incomplete. The Committee finds that testing positive during a competition is a violation and the Person failed to take precautions to reduce the risk of an anti-doping rule violation. The Committee further considers his degree of fault in this case and the delays in the proceedings not attributed to the Person.

Therefore the KNCB Disciplinary Committee decides on 9 February 2018 to impose a 8 month period of ineligibility on the Person starting backdated to 1 November 2017.

Fees and expenses for this committee shall be borne by the Person.