What urinary finding is classic for nephrotic-range proteinuria on dipstick?

• A. Proteinuria with a positive dipstick result; confirmed by a urine protein-to-creatinine ratio or 24-hour collection
• B. Hematuria with red blood cell casts
• C. Glucosuria
• D. Leukocyturia

Answer: (A)

The key idea is that nephrotic-range proteinuria is defined by a large amount of protein excreted in the urine, and a dipstick test detects the presence of protein. When protein is detected on the dipstick, that signals proteinuria, but to classify it as nephrotic-range you need a quantitative measure—typically the urine protein-to-creatinine ratio on a spot urine sample or a 24-hour urine collection showing at least 3.5 g of protein. The dipstick result by itself confirms there is protein in the urine, and the subsequent quantitative test confirms the nephrotic-range level.

The other findings—hematuria with red blood cell casts, glucosuria, and leukocyturia—point to different renal problems (such as nephritic syndrome, diabetes or proximal tubule issues, and infection/inflammation, respectively) and do not define nephrotic-range proteinuria on dipstick.