Fast Five Quiz: How Much Do You Know About Nephrotic Syndrome?

Vecihi Batuman, MD

Disclosures

July 19, 2017

A single spot urine collection is much easier to obtain. When the ratio of urine protein to urine creatinine is greater than 2 g/g, this corresponds to 3 g of urinary protein per day or more.

Urinalysis is the first test used in the diagnosis of nephrotic syndrome. Nephrotic-range proteinuria will be apparent by 3+ or 4+ readings on the dipstick, or by semiquantitative testing by sulfosalicylic acid. A 3+ reading represents 300 mg/dL of urinary protein or more, which correlates with a daily loss of 3 g or more and thus is in the nephrotic range. The chemistry of the dipsticks is such that albumin is the major protein that is tested.

The presence of more than 2 red blood cells per high-power field is indicative of microhematuria. Microhematuria may occur in membranous nephropathy and other causes of nephrotic syndrome but not in minimal-change nephropathy.

Urinary protein is measured by a timed collection or a single spot collection. A timed collection is typically done over a 24-hour period, starting at 7 AM and finishing the next day at the same time. In healthy individuals, less than 150 mg of total protein is present in a 24-hour urine collection.

For more on the workup of nephrotic syndrome, read here.

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