ALB and nephrotic syndrome: The clinical symptoms of most adult patients, whether primary or secondary MN, present mostly nephrotic syndrome, including albuminuria (>3.5 g/d), edema, low serum albumin (<30 g/L), and hyperlipidemia,119 with or without microscopic hematuria, while a few others only show protein loss on urinalysis (≤3.5 g/d).120, 121, 122