Some renal diseases are associated with hypercoagulability the most important is nephrotic syndrome, other diseases with multisystem affections are associated with renal diseases and vascular affection such as diabetes, systemic lupus erythematosus thrombotic thrombocytopenic purpura, disseminated intravascular coagulopathy and paroxysmal nocturnal hemoglobunuria. Vascular access for hemodialysis may be complicated by thrombosis. Renal transplantation may be complicated by thrombosis leading to graft thrombosis. The clinical presentation of hypercoagulable statemay be in the form of arterial thrombosis, venous thrombosis, pulmonary embolism.and renal vein thrombosis