Sport Sports Disciplines

Azotemia and Bodybuilding

Azotemia and Bodybuilding

by in Sport - Sports Disciplines

last updated: April 07, 2020

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Word to the expert: Davide Gariboldi explains how to deal with blood azotemia in bodybuilding and the importance of correctly balancing nutrition and training.

During my thirty-year career as a Personal Trainer, Athletic Trainer, and Diet Coach, I have had a lot of experience with the blood values ??of my clients. Even not being a Doctor and without diagnostic authority, I have a lot of experience learned in close contact with Dr. Roberto Dall’Aglio to whom I owe almost everything I know today.

Nutrition and training: two sides of the same coin

I have always dealt with not only the training of my customers but also with their nutrition. I believe that when a type of training is administered, which is like a medicine, I must be sure that my client has taken on an adequate calorie and macronutrient quota, so as not to incur, in the first place, unpleasant energy drops.


For example, if I prepare a very high-intensity workout for a woman, I always worry about asking how her nutrition was during that day, especially at the beginning of our working relationship. This is something that I learned very early, as in the first few months of my career I have had clients who eating indiscriminately very few calories, had problems during our lessons.


The problems encountered in these cases are, for example, nausea, weakness, a sense of fainting but these are only some of the negative effects that can be encountered if you train with an asynchronous intensity with your diet. So, as a personal trainer and diet coach, I always take care to stipulate a correct diet based on the objectives that the client sets me, after clearly having a history of the subject.

Protein quotas

When I prepare a correct diet for a person, I always worry first of all about having an adequate protein quota so as not to encounter a negative nitrogen balance, a preamble to a bankruptcy plan.

I have several parameters of protein percentages in a programmed diet: for example, if I use a ketogenic diet I know that I will never have to exceed 30% of the total calorie intake in proteins. Otherwise the latter would convert to glucose through gluconeogenesis, making us get out of that wonderful metabolic trick called ketosis. In another situation where, for example, I train a medium-high level bodybuilder, the protein quota applied during the competition periods will go up to 70% of the total caloric value.


I made this premise to highlight that all the clients that I follow in the gym or that I prepare for other high-level sports have a protein quota in their diet certainly higher than a sedentary person.

Those who know me know how scrupulous and picky I am about maintaining the health of my customers and their longevity at the top. This is why I usually ask for routine blood tests at least 2 times a year. This practice allows me to know in black and white if my client has any health problems and if nutrition, integration, and training are well structured and in perfect harmony with each other.

Azotemia and bodybuilding

Today I want to talk to you about a very specific value of blood tests: blood azotemia. What is blood nitrogen value? Nitrogen is the share of nitrogen that cannot be used, therefore not bound to proteins (which contain about 15% of total nitrogen Editor's note). Many times I find the classic asterisk "*" on the value of the blood test nitrogen, with the consequent concern of the customer who calls me in total panic. Let's clarify: the blood azotemia can be high for several factors.

  1. The first is the excess of proteins, which is used for energy and leaves this nitrogen unusable.
  2. The second can be severe muscle catabolism (quite remote).
  3. The third is severe renal impairment.

Almost all people who are not experts in hyper-protein nutrition immediately attribute this value to an overload of the kidney or its impaired function. Nothing more wrong. At least 95% of cases that I happen to read. This is rarely the case. The main value of kidney function is creatinine.

In this case, even small values ??beyond the creatinine range are to be taken seriously. While high levels of azotemia not. I often read nitrogen levels near 60 especially in advanced bodybuilders (normal values ??up to 50) but rarely without range creatinine.


We can therefore safely say (although not being a doctor I would not have authority to make any type of diagnosis) that high blood urea nitrogen in a person who follows a normal/hyper protein diet, like most of those who train in the gym for increasing muscle mass or to improve athletic performance is not a significant value of kidney damage or serious problems unless there is a creatinine value over the limit. In this case, the azotemia value could be high even by eating a few proteins. Or during very pronounced malnutrition.


We can say that high levels of nitrogen in subjects who take on a fairly high protein quota are not a worrying nor significant value if not confirmed by an out of range creatinine level. An appropriate note must be made regarding the daily water supply. I recommend from 3.5 to 8 liters of water per day for men and women. 1 liter of which I recommend it on an empty stomach, every day. Proteins are not kidneys or liver's enemies, the only caveat is that you have to drink a lot. With my clients keeping this behavior, kidney and liver problems are zero today.





  • William F Martin, Lawrence Armstrong and Nancy Rodriguez. Review: "Dietary protein intake and renal function." Nutrition & Metabolism 2005 2:25 DOI: 10.1186/1743-7075-2-25.
  • LaBounty, P, et al. (2005). Blood markers of kidney function and dietary protein intake of resistance trained males. J Int Soc Sports Nutr.2:5.
  • Eric L. Knight, MD, MPH, et. al. "The Impact of Protein Intake on Renal Function Decline in Women with Normal Renal Function or Mild Renal Insufficiency." Ann Intern Med. 2003;138(6):460-467.
  • Poortmans JR, Dellalieux O. "Do regular high protein diets have potential health risks on kidney function in athletes?" Int J Sport Nutr Exerc Metab. 2000 Mar;10(1):28-38.

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