All of the following decrease in nephrotic syndrome except
**Core Concept**
Nephrotic syndrome is characterized by severe proteinuria, leading to hypoalbuminemia, which in turn causes a decrease in oncotic pressure. This results in edema and various metabolic disturbances. The underlying pharmacological and physiological principles involve the regulation of fluid balance, electrolyte homeostasis, and lipid metabolism.
**Why the Correct Answer is Right**
In nephrotic syndrome, the liver increases the production of lipids in response to hypoalbuminemia, leading to hyperlipidemia. This is a compensatory mechanism to increase the production of proteins, including lipoproteins. As a result, the levels of cholesterol and triglycerides increase.
**Why Each Wrong Option is Incorrect**
**Option A:** Decreased oncotic pressure leads to edema, not an increase in a specific parameter.
**Option B:** Hypoalbuminemia is a hallmark of nephrotic syndrome, leading to decreased albumin levels.
**Option C:** The decrease in oncotic pressure leads to fluid shift from the vascular space to the interstitial space, causing edema.
**Clinical Pearl / High-Yield Fact**
Nephrotic syndrome is often associated with hypercoagulability due to the loss of anticoagulant proteins in the urine, such as antithrombin.
**Correct Answer:** D. Lipids