Nephrotic syndrome (NS) is associated with an elevated risk of venous thromboembolism (VTE), occurring in up to 25% of NS patients.1-3 Guidelines advocate for primary thromboprophylaxis in select NS patients.4 Warfarin, the most studied oral anticoagulant in NS, has been supplanted by direct oral anticoagulants in many other indications. Apixaban, a direct FXa inhibitor, has particular appeal owing to limited renal clearance and observational data suggesting it may be safe and effective with reduced glomerular filtration.