Nephrotic syndrome laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Nephrotic syndrome is characterized by the following laboratory findings: [[proteinuria]] > 3.5g/24 hrs on 24-hour urine collection, [[proteinuria]] on urine dipstick, and urine protein/creatinine ratio > 3. When nephrotic syndrome is diagnosed ([[proteinuria]] > 3.5 g/24 hrs), additional laboratory tests are required such as [[serum albumin]] concentration, | Nephrotic syndrome is characterized by the following laboratory findings: [[proteinuria]] > 3.5g/24 hrs on 24-hour urine collection, [[proteinuria]] on urine dipstick, and urine protein/creatinine ratio > 3. When nephrotic syndrome is diagnosed ([[proteinuria]] > 3.5 g/24 hrs), additional laboratory tests are required such as [[serum albumin]] concentration, serum chemistry panel, lipid panel, and serum [[creatinine]] concentration. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
For the diagnosis of nephrotic syndrome:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref> | For the diagnosis of nephrotic syndrome:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref> | ||
*24-hour urine collection shows proteinuria > 3.5g/24 hrs | *24-hour urine collection shows [[proteinuria]] > 3.5g/24 hrs | ||
*Urine dipstick confirms proteinuria | *Urine dipstick confirms [[proteinuria]] | ||
*Urine protein/creatinine ratio > 3 | *Urine protein/creatinine ratio > 3 | ||
<br>When nephrotic syndrome is diagnosed (proteinuria > 3.5 g/24 hrs), the following laboratory evaluation is needed:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref><ref name="pmid18497417">{{cite journal| author=Hull RP, Goldsmith DJ| title=Nephrotic syndrome in adults. | journal=BMJ | year= 2008 | volume= 336 | issue= 7654 | pages= 1185-9 | pmid=18497417 | doi=10.1136/bmj.39576.709711.80 | pmc=PMC2394708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18497417 }} </ref> | <br> | ||
*Low serum albumin | When nephrotic syndrome is diagnosed ([[proteinuria]] > 3.5 g/24 hrs), the following laboratory evaluation is needed:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref><ref name="pmid18497417">{{cite journal| author=Hull RP, Goldsmith DJ| title=Nephrotic syndrome in adults. | journal=BMJ | year= 2008 | volume= 336 | issue= 7654 | pages= 1185-9 | pmid=18497417 | doi=10.1136/bmj.39576.709711.80 | pmc=PMC2394708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18497417 }} </ref> | ||
*Serum chemistry panel is generally normal. Pseudohyponatremia due to hyperlipidemia may be present. | *Low serum [[albumin]] concentration | ||
*Serum chemistry panel is generally normal. Pseudohyponatremia due to [[hyperlipidemia]] may be present. | |||
*Abnormal lipid panel | *Abnormal lipid panel | ||
*Normal/elevated plasma creatinine | *Normal/elevated plasma [[creatinine]] concentration | ||
*Urine culture and antibiogram | *Urine culture and antibiogram | ||
*Bone profile and corrected calcium | *Bone profile and corrected [[calcium]] concentration | ||
<br>Other tests may be necessary to rule-out secondary etiologies of nephrotic syndrome:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref><ref name="pmid18497417">{{cite journal| author=Hull RP, Goldsmith DJ| title=Nephrotic syndrome in adults. | journal=BMJ | year= 2008 | volume= 336 | issue= 7654 | pages= 1185-9 | pmid=18497417 | doi=10.1136/bmj.39576.709711.80 | pmc=PMC2394708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18497417 }} </ref> | <br>Other tests may be necessary to rule-out secondary etiologies of nephrotic syndrome:<ref name="pmid19904897">{{cite journal| author=Kodner C| title=Nephrotic syndrome in adults: diagnosis and management. | journal=Am Fam Physician | year= 2009 | volume= 80 | issue= 10 | pages= 1129-34 | pmid=19904897 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19904897 }} </ref><ref name="pmid18497417">{{cite journal| author=Hull RP, Goldsmith DJ| title=Nephrotic syndrome in adults. | journal=BMJ | year= 2008 | volume= 336 | issue= 7654 | pages= 1185-9 | pmid=18497417 | doi=10.1136/bmj.39576.709711.80 | pmc=PMC2394708 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18497417 }} </ref> | ||
*C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) | *[[C-reactive protein]] (CRP) and [[erythrocyte sedimentation rate]] (ESR) | ||
*Fasting plasma glucose | *[[Fasting plasma glucose]] | ||
*Antinuclear antibody (ANA) panel | *[[Antinuclear antibody]] (ANA) panel | ||
*Anti-dsDNA antibodies | *[[Anti-dsDNA]] antibodies | ||
*Hepatic enzymes | *Hepatic enzymes | ||
*Serologic tests for HBV and HCV | *Serologic tests for [[HBV]] and [[HCV]] | ||
*HIV screening test | *[[HIV]] screening test | ||
*Rheumatoid factor | *[[Rheumatoid factor]] | ||
* | *[[Cryoglobulin]]s | ||
*Complement C3 and C4 levels | *Complement [[C3]] and [[C4]] levels | ||
*VDRL or RPR | *[[VDRL]] or [[RPR]] | ||
*Serum and urine protein electrophoresis | *Serum and urine [[protein electrophoresis]] | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | |||
[[Category:Medicine]] | |||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
[[Category: | [[Category:Emergency medicine]] | ||
Latest revision as of 22:57, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, Serge Korjian
Overview
Nephrotic syndrome is characterized by the following laboratory findings: proteinuria > 3.5g/24 hrs on 24-hour urine collection, proteinuria on urine dipstick, and urine protein/creatinine ratio > 3. When nephrotic syndrome is diagnosed (proteinuria > 3.5 g/24 hrs), additional laboratory tests are required such as serum albumin concentration, serum chemistry panel, lipid panel, and serum creatinine concentration.
Laboratory Findings
For the diagnosis of nephrotic syndrome:[1]
- 24-hour urine collection shows proteinuria > 3.5g/24 hrs
- Urine dipstick confirms proteinuria
- Urine protein/creatinine ratio > 3
When nephrotic syndrome is diagnosed (proteinuria > 3.5 g/24 hrs), the following laboratory evaluation is needed:[1][2]
- Low serum albumin concentration
- Serum chemistry panel is generally normal. Pseudohyponatremia due to hyperlipidemia may be present.
- Abnormal lipid panel
- Normal/elevated plasma creatinine concentration
- Urine culture and antibiogram
- Bone profile and corrected calcium concentration
Other tests may be necessary to rule-out secondary etiologies of nephrotic syndrome:[1][2]
- C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)
- Fasting plasma glucose
- Antinuclear antibody (ANA) panel
- Anti-dsDNA antibodies
- Hepatic enzymes
- Serologic tests for HBV and HCV
- HIV screening test
- Rheumatoid factor
- Cryoglobulins
- Complement C3 and C4 levels
- VDRL or RPR
- Serum and urine protein electrophoresis
References
- ↑ 1.0 1.1 1.2 Kodner C (2009). "Nephrotic syndrome in adults: diagnosis and management". Am Fam Physician. 80 (10): 1129–34. PMID 19904897.
- ↑ 2.0 2.1 Hull RP, Goldsmith DJ (2008). "Nephrotic syndrome in adults". BMJ. 336 (7654): 1185–9. doi:10.1136/bmj.39576.709711.80. PMC 2394708. PMID 18497417.