Although the misuse of androgenic-anabolic steroids is increasing, not much research has been done to determine how it affects renal function. Our research sought to ascertain how Nandrolone decanoate (ND) treatment affected kidney function and histological changes in adult male albino rats. Additionally, we sought to evaluate the impact of combining ND therapy with anaerobic exercise. A total of 39 male rats were divided into three groups (n = 13 each): control, ND treated (15mg/kg/day for 8 weeks; SC), and trained-ND treated (8-12 ladder climbs, three times per week for eight weeks). Blood and kidney samples were taken after eight weeks of anaerobic exercise and therapy. The study assessed organ weight, serum urea, and creatinine levels, inflammation (TNF-α, IL-6), oxidative stress markers (MDA, SOD, TAC), kidney histology, and collagen content. Caspase3 and BAX immunohistochemistry were performed, whereas Sirt1, Beclin-1, and microtubule-associated protein light chain 3 (LC3) mRNA were analyzed using RT-PCR. The current study illustrated that exercise significantly improved kidney function, histological results, and damage score while reducing collagen deposition, inflammation, and oxidative stress. Apoptosis proteins (CASPASE3 and BAX) were dramatically reduced, whereas Sirt1 and autophagy proteins (Beclin-1 and LC3) mRNA levels were increased. In our conclusion, because of its anti-inflammatory, antioxidative, and antiapoptotic properties as well as its modification of autophagy protein mRNA, anaerobic exercise in conjunction with ND administration in rats led to a reduction in renal damage and kidney fibrosis.