In the nephrotic syndrome case, which serum abnormality would you expect?

In the nephrotic syndrome case, which serum abnormality would you expect?

• A. Increased albumin
• B. Decreased urea nitrogen
• C. Decreased albumin
• D. Normal creatinine

Answer: (C)

Massive protein loss in nephrotic syndrome lowers the amount of albumin in the blood. This hypoalbuminemia is the defining serum change, because albumin is the main protein lost through the kidneys in this condition, which also helps explain the edema seen in patients. The liver may respond by making more lipids, so hyperlipidemia can occur as a secondary feature, but the hallmark serum abnormality is decreased albumin. Creatinine can be normal if kidney function is preserved, and urea nitrogen levels can vary, not typically decreasing. So the most expected serum abnormality is decreased albumin.

Massive protein loss in nephrotic syndrome lowers the amount of albumin in the blood. This hypoalbuminemia is the defining serum change, because albumin is the main protein lost through the kidneys in this condition, which also helps explain the edema seen in patients. The liver may respond by making more lipids, so hyperlipidemia can occur as a secondary feature, but the hallmark serum abnormality is decreased albumin. Creatinine can be normal if kidney function is preserved, and urea nitrogen levels can vary, not typically decreasing. So the most expected serum abnormality is decreased albumin.