Which kidney pathology is associated with increased LDL/VLDL?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Glomerulonephritis
• D. Hydronephrosis

Answer: (A)

Nephrotic syndrome is associated with a distinctive lipid abnormality: marked hyperlipidemia with elevated LDL and VLDL. The driving force is hypoalbuminemia from heavy proteinuria, which lowers plasma oncotic pressure and stimulates the liver to ramp up synthesis of lipoproteins to help transport triglycerides and maintain oncotic balance. This hepatic overproduction, combined with impaired clearance of triglyceride-rich particles, leads to increased circulating LDL and VLDL. In contrast, the other kidney conditions listed do not characteristically cause this lipid pattern; they may involve edema or renal injury, but persistent LDL/VLDL elevation is not a defining feature.