PLG and metabolic syndrome: Exposure to inflammation, oxidative stress, dyslipidemia, and hypoalbuminemia, all common in NS, can compromise endothelial function and downregulate protective mechanisms such as the antithrombin and protein C pathways.40 These changes may also impair fibrinolysis through reduced plasmin generation or increased expression of fibrinolytic inhibitors, consistent with our observation of prolonged clot lysis time.44