Nephrotic syndrome laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

The following are baseline, essential investigations:

• Urine samples show proteinuria. The samples may also be examined for active casts; which is more a feature of active nephritis.
• Hypoalbuminemia: albumin levels in blood < 30g/L
• High levels of cholesterol (hypercholesterolemia), specifically elevated LDL, usually with concomitantly elevated VLDL
• The classic Maltese cross pattern is evident in fatty casts with polarized microscopy because of the birefringence of the lipid. Maltese crosses are due to cholesterol, which is increased in nephrotic syndrome.
• Electrolytes, urea and creatinine (EUCs): to evaluate renal function

Tests to rule out various causes may include the following:

• Glucose tolerance test
• Antinuclear antibody
• Rheumatoid factor
• Cryoglobulins
• Complement levels
• Hepatitis B and C antibodies
• VDRL serology
• Serum protein electrophoresis

This disease may also alter the results of the following tests:

• Urinary casts
• Serum iron