A 29-year-old female has significant lower extremity edema and protein loss in urine. Which additional lab finding is she most likely to present with?

The presence of significant lower extremity edema and protein loss in urine suggests the potential diagnosis of nephrotic syndrome. This condition is characterized by heavy proteinuria, hypoalbuminemia, and edema. One of the key metabolic changes associated with nephrotic syndrome is dyslipidemia, which often includes elevated levels of low-density lipoprotein (LDL) cholesterol.

In nephrotic syndrome, the liver compensates for the loss of proteins, particularly albumin, by synthesizing more lipoproteins, including LDL. Therefore, it is common to see elevated LDL levels in these patients as a direct physiological response to the hypoalbuminemia and resultant alterations in lipid metabolism.

While decreased HDL may occur in some cases of nephrotic syndrome, the elevation of LDL is more prominent and directly linked to the metabolic derangements related to the protein loss and edematous state. Consequently, the lab finding of elevated LDL is the most likely and relevant in the context of the described clinical presentation.