Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia (serum albumin <2.5 g/dl), hyperlipidemia (serum cholesterol >200 mg/dl), and edema.1, 2Nephrotic range proteinuria is present if early morning urine protein is 3+/4+ (on dipstick or boiling test), spot protein/creatinine ratio >2 mg/mg, or urine albumin excretion >40 mg/m2 per hour (on a timed-sample). The gene discussed is ALB; the disease is nephrotic syndrome.