OBJECTIVE To investigate the efficacy and safety of rivaroxaban in prophylactic anticoagulation therapy of nephrotic syndrome(NS).

METHODS The data of patients diagnosed with NS in the Department of Nephrology of Guizhou Provincial People’s Hospital from October 2021 to June 2025 were collected, and the inclusion and exclusion criteria were set. After screening, and they were grouped based on whether they used anticoagulant medications prophylactically and the type of anticoagulant medication used. They were divided into rivaroxaban group(37 cases), warfarin group(29 cases), and non-anticoagulation group(32 cases). The basic conditions before treatment of the three groups were statistically analyzed, and the incidence of thrombosis and bleeding in the three groups 6 months after medication.

RESULTS There was no significant difference in the incidence of new thrombosis between the rivaroxaban group and the warfarin group after treatment, while there was a significant difference in the incidence of new thrombosis between the rivaroxaban group and the non-anticoagulation group(P<0.05), the new thrombotic events in the rivaroxaban group were significantly reduced compared with the non-anticoagulation group. There were two bleeding events in the rivaroxaban group, five bleeding events in the warfarin group, one case of bleeding occurred in the group without anticoagulation. There was no significant difference in the incidence of bleeding between the three groups.

CONCLUSION This study shows that rivaroxaban has certain effectiveness and safety in the prevention and anticoagulation therapy of patients with NS.