40 Sec Q Breakdown – GI 5 If you’re wondering when to start prophylactic anticoagulation in a patient with nephrotic syndrome, the key lab value isn’t LDL or blood pressure, it’s low serum albumin. Here’s why: \t1.\tMassive protein loss = loss of antithrombin III, your body’s natural anticoagulant. Without it, the risk of thrombosis shoots up. \t2.\tLow albumin causes edema by shifting fluid out of vessels. What’s left behind? Thick, sluggish blood. That hemoconcentration and stasis leads to clo