{
  "abstract": "Background: The high incidence of nephrotic syndrome (NS) in adults imposes a heavy burden on families and public health care systems, highlighting the significance of early and accurate diagnosis.\n\nObjectives: To develop and internally validate a predictive model and scoring system for diagnosing NS in adults.\n\nMethods: This retrospective diagnostic prediction study enrolled 8,950 hospitalized adults with a preliminary diagnosis of NS and evidence of proteinuria from the First Affiliated Hospital of Xinjiang Medical University. The dataset was randomly divided into a training set and an internal validation set at a 7:3 ratio. Missing data were imputed separately within each set. LASSO regression was used for variable selection in the training set. Variables with univariate P < 0.05 were entered into a multivariable logistic model using bidirectional stepwise selection. Model discrimination, calibration, and clinical utility were evaluated. Internal validation was performed using the bootstrap-impute-predict framework with 500 bootstrap samples. A diagnostic scoring system and risk stratification were subsequently developed.\n\nResults: LASSO regression retained 10 key variables, and the final multivariable logistic model included 9 variables: age, hypertension, hyperlipidemia, edema, 24-hour urinary protein excretion, urine protein qualitative result, serum albumin, cystatin C, and D-dimer. The likelihood ratio tests were statistically significant in both the training and internal validation sets (both P < 0.001). The apparent AUC was 0.89 (95% CI: 0.89–0.90) in the training set, and the Harrell-corrected AUC remained 0.89 after 500 bootstrap resamples. The AUC was 0.90 (95% CI: 0.89–0.91) in the internal validation set. Calibration curves indicated good agreement, and decision curve analysis demonstrated clinical net benefit. Sensitivity analyses further supported the robustness of the model. The score-based system effectively distinguished patients with different risks of NS, and the observed proportion of patients with NS increased progressively with higher scores.\n\nConclusions: In hospitalized adults with suspected NS and evidence of proteinuria, this model and scoring system may support early diagnostic assessment and risk stratification, pending external validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Dermatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xiaoyang Dong"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Nie"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Yan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5gwds4n1vfwyq.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1825840",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730878/",
  "id": "5gwds4n1vfwyq",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1825840",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2727|Renal Diseases and Glomerulopathies"
    ]
  ],
  "openalex": "W7223156922",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1825840/pdf",
  "pmcid": "PMC13730878",
  "pmid": "42984836",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5gwds4n1vfwyq.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:51Z",
      "native_id": "PMC13730878",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1825840"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Renal Diseases and Glomerulopathies",
      "subfield": "general"
    }
  ],
  "title": "Development and validation of a clinical prediction model for diagnosing nephrotic syndrome in adults: a retrospective diagnostic prediction study",
  "title_text": "Development and validation of a clinical prediction model for diagnosing nephrotic syndrome in adults: a retrospective diagnostic prediction study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:11Z",
  "url": "https://research.draconitic.com/paper/5gwds4n1vfwyq",
  "venue": "Frontiers in Medicine",
  "versions": []
}