Which finding is typical of nephritic syndrome?

• A. Hematuria with red blood cell casts
• B. Heavy proteinuria with hypoalbuminemia
• C. Severe hyperlipidemia
• D. Massive protein loss with edema

Answer: (A)

Nephritic syndrome centers on inflammation of the glomeruli causing blood to leak into the urine, and red blood cell casts form when red cells pass through damaged glomeruli and are then shaped into casts in the tubules. Seeing hematuria with red blood cell casts directly reflects glomerular bleeding and inflammation, making it the classic finding for this condition. In contrast, heavy proteinuria with hypoalbuminemia and edema point to nephrotic syndrome, and severe hyperlipidemia is also a feature of nephrotic presentations. So, the presence of hematuria with red blood cell casts best identifies nephritic syndrome.