**2.2.2 Decrease endogenous anticoagulants**

In the nephrotic syndrome the hypercoagulable state is distinguished by an increase in coagulation factors (V, VIII and fibrinogen) a decrease in the levels of antitrombin III and S Proteins, an increase in alpha 2 antiplasmin activity and exaggerated platelet adhesiveness and aggregation. This prothrombotic state may be aggravated by additional rheological factors (immobilization, diuretic therapy, etc.) (Keusch, 1989; Adams, 2008).

The lower level of antithrombin III in patients with nephrotic syndrome is probably due to increased urinary loss.(Vaziri, 1984).
