In nephrotic syndrome, edema commonly results from decreased oncotic pressure and is often associated with hyperlipidemia.

• A. Edema is due to dehydration.
• B. Nephrotic syndrome commonly causes edema due to decreased oncotic pressure and is often associated with hyperlipidemia.
• C. Hyperlipidemia is never seen in nephrotic syndrome.
• D. Hyperlipidemia is caused by increased albumin production.

Answer: (B)

Nephrotic syndrome causes heavy loss of protein in the urine, especially albumin, which lowers the circulating plasma oncotic pressure. When oncotic pressure drops, fluid shifts from the vascular space into the interstitial space, leading to edema. At the same time, the liver responds to low albumin by increasing production of lipoproteins, producing hyperlipidemia. So the edema arises from decreased oncotic pressure, and hyperlipidemia is a common accompanying feature. This edema is not due to dehydration, and hyperlipidemia is indeed seen in nephrotic syndrome, not absent. Hyperlipidemia isn’t caused by increased albumin production; it results from the liver’s compensatory response to hypoalbuminemia.