All of the following are decreased in nephrotic syndrome, except ?
**Core Concept**
Nephrotic syndrome is characterized by significant loss of protein through the urine, leading to hypoalbuminemia, hyperlipidemia, and edema. The kidneys' ability to reabsorb proteins is impaired, resulting in excessive urinary loss.
**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of nephrotic syndrome. In this condition, the kidneys' ability to reabsorb proteins is impaired, leading to excessive urinary loss of albumin, globulins, and other proteins. This results in decreased levels of these proteins in the blood. However, the kidneys' ability to reabsorb lipids is also impaired, leading to increased levels of lipids in the urine.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because albumin, a major plasma protein, is indeed decreased in nephrotic syndrome due to excessive urinary loss.
**Option B:** This option is incorrect because globulins, a group of proteins that include antibodies and clotting factors, are also decreased in nephrotic syndrome due to excessive urinary loss.
**Option C:** This option is incorrect because lipid-binding proteins, such as lipoproteins, are decreased in nephrotic syndrome due to excessive urinary loss.
**Clinical Pearl / High-Yield Fact**
In nephrotic syndrome, the kidneys' ability to reabsorb proteins is impaired, leading to excessive urinary loss of albumin, globulins, and other proteins. This results in decreased levels of these proteins in the blood, which can lead to complications such as edema, hyperlipidemia, and increased risk of infections.
**Correct Answer: D. Lipid-binding proteins are actually increased in nephrotic syndrome due to increased synthesis in response to hypoalbuminemia, not decreased.**