Approach to the patient with nephrotic syndrome

Abstract

A 50-year-old woman with no significant past medical history acutely develops bilateral lower extremity pitting edema. A thorough evaluation of cardiac and hepatic functions is unremarkable; however, urinalysis reveals significant proteinuria. Further testing shows an elevated serum creatinine level of 1.8 mg/dL, low serum albumin level of 2.2 g/dL, and hyperlipidemia (total cholesterol 385 mg/dL, triglycerides 480 mg/dL, LDL 245 mg/dL, and HDL 44 mg/dL). Urinary protein measures 5.2 g in a 24-h collection. The clinical diagnosis of nephrotic syndrome is made.