Nephrotic syndrome laboratory findings: Difference between revisions
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*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><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>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>: | ||
*Low serum albumin levels | *Low serum albumin levels | ||
*Serum chemistry panel is generally normal. Pseudohyponatremia due to hyperlipidemia may be present. | *Serum chemistry panel is generally normal. Pseudohyponatremia due to hyperlipidemia may be present. | ||
| Line 17: | Line 17: | ||
*Bone profile and corrected calcium levels | *Bone profile and corrected calcium levels | ||
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 | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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 levels
- Serum chemistry panel is generally normal. Pseudohyponatremia due to hyperlipidemia may be present.
- Abnormal lipid panel
- Normal/elevated plasma creatinine levels
- Urine culture and antibiogram
- Bone profile and corrected calcium levels
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.