Exams and Tests

In addition to a medical history and physical exam, other tests to diagnose nephrotic syndrome include:

• A 24-hour urine collection, which measures the total amount of protein in the urine collected over 24 hours. You will be diagnosed with nephrotic syndrome if you have more than 3 grams of protein in your urine.
• Blood test for albumin. Lower levels of albumin in the blood can cause fluid to collect in the ankles, lungs, or abdomen.
• Creatinine and creatinine clearance. Results of these tests give information on how well your kidneys are working.
• Blood profile tests to measure the amount of protein, cholesterol, and sugar (glucose) in the blood.
• Kidney ultrasound to look at the kidneys. This exam can rule out other causes of your symptoms.

You may need other tests before treatment for nephrotic syndrome begins. These include:

• A test for varicella (chickenpox) antibodies.
• A bone density scan.

In adults, testing usually includes:

• Serum protein electrophoresis (SPEP).
• Antinuclear antibodies (ANA).
• Antibody tests for systemic lupus erythematosus.
• C3 and C4 complement, proteins normally found in the blood.
• Tests for hepatitis B, hepatitis C, and HIV.

Unless nephrotic syndrome is clearly caused by diabetes, a kidney biopsy is usually done to find the cause. Children do not usually have a biopsy.