Nephrotic syndrome laboratory findings
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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 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.