Nephrotic syndrome is characterized by which combination?

• A. Proteinuria with edema, hypoalbuminemia, and hyperlipidemia
• B. Hematuria with hypertension and azotemia
• C. Proteinuria with hyperkalemia and edema
• D. Hypoalbuminemia with increased BUN and creatinine

Answer: (A)

Nephrotic syndrome is defined by heavy protein loss in the urine, which leads to low serum albumin and edema, with the liver compensating by increasing lipoprotein production, causing hyperlipidemia. This combination—proteinuria with edema, hypoalbuminemia, and hyperlipidemia—captures the characteristic pattern: large amounts of protein spill into the urine reduce the blood’s oncotic pressure, pulling fluid into tissues and producing edema; the drop in albumin drives hepatic lipoprotein synthesis, raising blood lipids.

The other scenarios don’t fit the classic nephrotic picture. Hematuria with hypertension and azotemia aligns more with nephritic syndrome, which involves inflammation and bleeding in the glomeruli rather than massive protein loss. A proteinuria plus hyperkalemia and edema lacks the defining hyperlipidemia of nephrotic syndrome. Hypoalbuminemia with increased BUN and creatinine describes renal dysfunction that may accompany many conditions but does not specify the heavy protein loss and lipid abnormalities that define nephrotic syndrome.