What is the hallmark triad of nephrotic syndrome?

• A. Proteinuria, hypoalbuminemia, edema
• B. Hematuria, edema, hypertension
• C. Proteinuria, hematuria, azotemia
• D. Hypoalbuminemia, hyperkalemia, edema

Answer: (A)

The defining idea is that nephrotic syndrome features heavy protein loss in the urine with resulting low blood protein and fluid accumulation. The best answer reflects the classic triad: proteinuria, hypoalbuminemia, and edema. When the kidneys leak large amounts of protein, serum albumin falls (hypoalbuminemia), which lowers the plasma oncotic pressure and allows fluid to shift into tissues, causing edema. Although lipid abnormalities can accompany nephrotic syndrome, they’re not part of the hallmarked triad. In contrast, hematuria and hypertension are more typical of nephritic syndrome, and while kidney dysfunction can cause azotemia or electrolyte issues, they aren’t defining features of the nephrotic triad.