Prednisone can affect this through 2 different nutrient pathways: Potassium, Magnesium. This medication is commonly used for Inflammation.
Each nutrient below contributes to this impact through a different mechanism.
When potassium levels run low for a sustained period, potassium deficiency can promote renal dysfunction by triggering structural and functional changes in the kidney, including impaired concentrating ability, increased ammonia production, and tubulointerstitial injury that may quietly progress over time. Experimental and clinical observations link hypokalemia with renal cyst formation, reduced glomerular filtration, and a higher risk of nephropathy, particularly when low potassium coexists with high blood pressure or diabetes. The encouraging finding is that in some cases, correcting potassium deficiency can partially reverse early functional abnormalities and slow kidney damage, underscoring that low potassium is not just a marker of illness but a modifiable contributor to long‑term kidney health.
Yalamanchili HB, Calp-Inal S, Zhou XJ, Choudhury D. Hypokalemic Nephropathy. Kidney Int Rep. 2018 Jul 21;3(6):1482-1488. Bock KD, Cremer W, Werner U. Chronic hypokalemic nephropathy: a clinical study. Klin Wochenschr. 1978;56 Suppl 1:91-6. Carney SL, Morgan TO. Diuretic-induced hypokalemia and altered renal function. Int J Clin Pharmacol Ther Toxicol. 1986 Dec;24(12):665-7. PMID: 3546168. Torres VE, Young WF Jr, Offord KP, Hattery RR. Association of hypokalemia, aldosteronism, and renal cysts. N Engl J Med. 1990 Feb 8;322(6):345-51.
Impaired renal magnesium reabsorption from low or depleted magnesium levels carries a notable association with worse kidney outcomes, shown by adjusted odds ratios of 1.7–3.0 in affected patients. This contributes to electrolyte imbalances and may worsen overall kidney function over time, with studies reporting hypomagnesemia in nearly a quarter of patients who already have impaired renal function. Monitoring renal function and magnesium status remains crucial for at-risk individuals to avert complications such as acute kidney injury or hospitalization.
Ferrè S, Li X, Adams-Huet B, Maalouf NM, Sakhaee K, Toto RD, Moe OW, Neyra JA. Low serum magnesium is associated with faster decline in kidney function: the Dallas Heart Study experience. J Investig Med. 2019 Aug;67(6):987-994.Steven Van Laecke, Wim Van Biesen, Raymond Vanholder, Hypomagnesaemia, the kidney and the vessels, Nephrology Dialysis Transplantation, Volume 27, Issue 11, November 2012, Pages 4003–4010. Sarah Cascaes Alves, Cristiane Damiani Tomasi, Larissa Constantino, Vinícius Giombelli, Roberta Candal, Maria de Lourdes Bristot, Maria Fernanda Topanotti, Emmanuel A. Burdmann, Felipe Dal-Pizzol, Cassiana Mazon Fraga, Cristiane Ritter, Hypomagnesemia as a risk factor for the non-recovery of the renal function in critically ill patients with acute kidney injury, Nephrology Dialysis Transplantation, Volume 28, Issue 4, April 2013, Pages 910–916. Liu Z, Wang R, He M, Kang Y. Hypomagnesemia Is Associated with the Acute Kidney Injury in Traumatic Brain Injury Patients: A Pilot Study. Brain Sci. 2023 Mar 31;13(4):593.
Some side effects may be linked to nutrient depletion caused by this medication.
Research has found that corticosteroids increased chromium excretion in patients after just three days. Chromium is an essential mineral that helps regulate blood sugar levels. This is important because corticosteroids themselves can raise blood sugar, contributing to diabetes. Evidence suggests that chromium supplementation improved fasting blood glucose levels in patients with steroid-induced diabetes.
Maintaining healthy potassium levels is important when taking corticosteroids. These medications can increase the amount of potassium the body loses through urine. Potassium is a vital mineral that helps muscles and nerves function properly. While short-term use of corticosteroids might not cause significant problems, studies suggest that with prolonged treatment, the body's ability to maintain proper potassium balance (homeostasis) can be affected.
Corticosteroids can lower calcium levels in the body. This is a double threat to bone health because corticosteroids themselves can weaken bones. Calcium is essential for strong bones, and a study showed that supplementing with both calcium and vitamin D3 helped prevent bone loss in people with rheumatoid arthritis taking corticosteroids. Supplementation with calcium should be considered during long term corticosteroid therapy.
Corticosteroids can increase the urinary loss of selenium elevating the risk for deficient levels. Selenium is a mineral that acts as an antioxidant, helping protect cells from damage. Studies have shown that rheumatoid arthritis patients taking high doses of corticosteroids tend to have lower selenium levels. This is concerning because low selenium intake is linked to osteoporosis, and selenium has been shown to play a role in bone protection in animal models of corticosteroid-induced osteoporosis. Supplementation with selenium should be considered during long term corticosteroid therapy.
Corticosteroids can increase the body's excretion of magnesium, potentially leading to a deficiency. This is concerning because magnesium plays a vital role in many bodily functions, including muscle and nerve function. Research suggests that magnesium supplementation alleviated corticosteroid therapy associated muscle atrophy. Supplementation with magnesium should be considered during long term corticosteroid therapy.
Research suggests corticosteroids can lower vitamin D levels in the body by increasing its breakdown. This is a concern because vitamin D plays a crucial role in bone health and the immune system, and corticosteroids themselves can weaken bones. A study found that calcium and vitamin D3 supplements helped prevent bone loss in the lower back (lumbar spine) and hip (trochanter) for people with rheumatoid arthritis who were on low-dose corticosteroids. Evidence suggests vitamin D may work synergistically together with corticosteroids to improve asthma treatment by boosting the effectiveness of corticosteroids or by overcoming resistance to these medications in some patients.