Chronic kidney disease may develop as a consequence of various environmental and lifestyle factors, including the use of anabolic‑androgenic steroids, high‑protein diets, and dietary supplementation. This case report presents a 45‑year‑old male powerlifter who was admitted to the hospital emergency department with exertional dyspnoea and reduced exercise tolerance. Laboratory tests revealed end‑stage renal failure (creatinine 23.2 mg/dL, eGFR 2 mL/min/1.73 m2), anaemia, proteinuria, and markedly elevated creatine kinase levels. The patient reported long‑term use of anabolic-androgenic steroids, a diet containing up to 3 g of protein per kilogram of body weight per day, and the intake of various unspecified dietary supplements. Kidney biopsy revealed extensive chronic and acute changes characteristic of nephropathy associated with anabolic‑androgenic steroid use and long‑standing hypertension. Conservative treatment proved ineffective, so haemodialysis therapy was initiated. During the hospitalisation, the patient developed pulmonary embolism and hospital‑acquired pneumonia, the proper treatment was initiated and intesified. He was discharged in satisfactory condition with a recommendation to continue renal replacement therapy. The presented case highlights the risk of irreversible kidney damage associated with long‑term use of performance‑enhancing substances and an improper diet, underscoring the need for preventive and interventional efforts within the athletic population.