In nephrotic syndrome, which lipid abnormality is commonly observed?

• A. Hypolipidemia
• B. Hyperlipidemia
• C. Normal lipid levels
• D. Hyperlipidemia with low triglycerides

Answer: (B)

In nephrotic syndrome, a major clue is the loss of protein in the urine (proteinuria) leading to low plasma albumin (hypoalbuminemia). The body compensates by increasing hepatic production of proteins, including lipoproteins. This hepatic response raises the circulating lipids, so you see elevated cholesterol and triglycerides—hyperlipidemia. Practically, triglycerides are typically increased along with cholesterol, and LDL/VLDL rise as part of this pattern, while HDL can be normal or decreased. That’s why the lipid abnormality you’d expect in nephrotic syndrome is hyperlipidemia. Hypolipidemia or normal lipid levels wouldn’t fit this pathophysiology, and hyperlipidemia with low triglycerides isn’t characteristic because triglycerides are usually elevated too.