A patient presents with edema in the hands and face, proteinuria, hypoalbuminemia, and hyperlipidemia. What is the most likely diagnosis?

The presentation of edema in the hands and face, proteinuria, hypoalbuminemia, and hyperlipidemia points towards nephrotic syndrome as the most likely diagnosis. Nephrotic syndrome is characterized by significant proteinuria, which leads to lowered serum albumin levels (hypoalbuminemia). The decrease in plasma oncotic pressure due to low albumin results in edema, which can be generalized or localized, often affecting areas like the hands and face. Hyperlipidemia is also commonly associated with nephrotic syndrome due to compensatory mechanisms in response to low protein levels.

In contrast, other conditions such as congestive heart failure and end-stage liver disease can present with edema but are typically accompanied by different laboratory findings and clinical features. Malnutrition could cause some of the edema and hypoalbuminemia but would not typically present with significant proteinuria or hyperlipidemia to the extent seen in nephrotic syndrome. Thus, the combination of symptoms makes nephrotic syndrome the clear diagnosis in this clinical scenario.