Nephrotic syndrome laboratory findings: Difference between revisions

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{{Nephrotic syndrome}}
{{Nephrotic syndrome}}
{{CMG}}
{{CMG}}; {{AE}} [[User:YazanDaaboul|Yazan Daaboul]], [[User:Sergekorjian|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==
==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


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>:
<br>
*Low serum albumin levels
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 levels
*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<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>:
<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>
*Fasting plasma glucose
*[[C-reactive protein]] (CRP) and [[erythrocyte sedimentation rate]] (ESR)
*Antinuclear antibody (ANA) panel
*[[Fasting plasma glucose]]
*[[Antinuclear antibody]] (ANA) panel
*[[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]]
*Cryoglobulins
*[[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]]
 
==Renal Biopsy==
Renal biopsy is usually recommende for patients with nephrotic syndrome. Renal biopsy provides diagnostic and prognostic benefit. However, guidelines that define the timing and the circumstances to perform renal biopsy are not present. In minimal change disease, the most common primary cause of nephrotic syndrome in children, and in diabetic nephropathy, the most common secondary cause of nephrotic syndrome in adults, renal biopsy is not generally recommended and is not routinely performed.<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>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Kidney diseases]]
 
[[Category:Medicine]]
[[Category:Nephrology]]
[[Category:Nephrology]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]
[[Category:Disease]]
[[Category:Emergency medicine]]
[[Category:Syndromes]]
[[Category:Primary care]]
[[Category:Needs overview]]
 
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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]

References

  1. ↑ 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. ↑ 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.
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