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Background Nephrotic syndrome (NS) results in massive proteinuria and hypoalbuminemia, which are responsible for a compensatory increase in protein synthesis in the liver. Serum cholinesterase (ChE) also increases in NS. However, its clinical value is not fully elucidated. Methods In this study, 184 patients with NS who underwent kidney biopsy were included. The patients were divided into two groups according to serum ChE levels, as follows: hypercholinesterasemia (HC) and non-hypercholinesterasemia (NHC) groups. The clinical factors were compared between the two groups. Results The HC group had significantly more severe proteinuria and higher prevalence of high selective proteinuria than the NHC group. Furthermore, the prevalence of minimal change nephrotic syndrome (MCNS) was significantly higher in the HC group than that in the NHC group. Multivariate analysis revealed that the severity of proteinuria and MCNS were significantly associated with HC. Conclusion In this study, HC in NS was associated with the severity of proteinuria and MCNS, and could help clinicians predict the histological diagnosis of NS.

Clinical value of serum cholinesterase levels in Nephrotic syndrome: an observational study