Which condition is most commonly associated with lipiduria?

• A. Nephritic syndrome
• B. Acute tubular necrosis
• C. Nephrosclerosis
• D. Nephrotic syndrome

Answer: (D)

Lipiduria shows lipids in the urine due to marked protein loss in the urine. In nephrotic syndrome, massive proteinuria leads to hypoalbuminemia and edema, and the liver compensates by making more lipoproteins, causing hyperlipidemia. The filtered lipids and lipoproteins end up in the urine, often seen as lipid-laden tubular cells or oval fat bodies, which can appear as Maltese crosses under polarized light. This combination of heavy proteinuria, edema, and lipiduria is most characteristic of nephrotic syndrome, making it the condition most commonly associated with lipiduria. The other conditions listed involve inflammation, tubular injury, or vascular changes and do not typically present with lipiduria.