Safety and efficacy of apixaban in patients with glomerulonephritis and nephrotic syndrome: a prospective longitudinal cohort study

Aim. Assessment of the efficacy and safety of apixaban in preventing thromboembolic complications in patients with nephrotic syndrome caused by primary glomerulonephritis. Materials and methods. We conducted a prospective longitudinal cohort study involving 125 patients with glomerulonephritis and nephrotic syndrome. According to the inclusion criteria, patients had to be over 18 years of age, diagnosed with nephrotic syndrome within the last month, and have an estimated glomerular filtration rate greater than 60 ml/min/1.73 m². The study population was divided into two cohorts for comparison: one group (62 patients) received prophylactic anticoagulation with warfarin, while the other group (63 patients) was administered apixaban at a dose of 5 mg twice daily. The observation period was 6 months. Results. During the observation period, no thromboembolic events were reported in either group, indicating the effectiveness of both treatments. However, minor bleeding events were significantly more frequent in the warfarin group than in the apixaban group (p = 0.003). These findings suggest that apixaban is associated with a lower risk of bleeding while maintaining effective thromboembolic prevention. Conclusions. This study highlights that apixaban is a potentially better alternative to warfarin for thromboprophylaxis in patients with nephrotic syndrome and glomerulonephritis, particularly in those at high thromboembolic risk. Further randomized controlled trials are recommended to confirm these findings and optimize anticoagulation strategies for this population.