ArticleClinical and experimental nephrology2026
Coexistence of ANCA-associated glomerulonephritis and membranous nephropathy: a scoping review.
Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCoexistence of anti-neutrophil cytoplasmic antibody -associated glomerulonephritis (ANCA-GN) and membranous nephropathy (MN) is rare. This scoping review mapped evidence on clinicopathologic features, phenotypic heterogeneity, and reporting gaps relevant to future rigorous phenotype-specific comparative studies.
methodsComprehensive searches of PubMed, Web of Science, and CENTRAL from inception to April 16, 2026 identified original studies of patients with coexisting ANCA-GN and MN. Two reviewers independently extracted study and participant characteristics, renal and systemic findings, serologic and antigen data, associated conditions, treatments, outcomes, phenotype categories, and temporal relationships. Individual-level cases were assigned using a prespecified phenotype framework.
resultsSeventy studies (140 patients) were included, comprising 113 individually charted cases and one aggregate-only cohort of 27 patients. Among individual-level cases, median age was 60 years; median serum creatinine, 2.75 mg/dL; and median proteinuria, 3.7 g/day or g/g creatinine (g/gCr). The overlap was phenotypically heterogeneous, including 66 likely myeloperoxidase (MPO)-associated/ANCA-GN-related cases, 10 likely primary-MN-like overlap cases, 31 secondary/associated cases, and 6 unclassifiable cases. Temporal relationship was ascertainable for all 113 cases: 101 (89.4%) had concurrent onset (≤ 6 months), 7 (6.2%) had MN preceding ANCA-GN, and 5 (4.4%) had ANCA positivity preceding MN. The evidence base was constrained by case-report predominance, selective antigen testing, sparse longitudinal biomarker/follow-up data, and nonuniform outcome reporting.
conclusionsCoexisting ANCA-GN and MN is a rare, clinically important, and heterogeneous spectrum rather than a single pooled entity. Future studies should use phenotype-specific designs with standardized antigen testing, crescent reporting, longitudinal ANCA assessment, consistent outcome definitions, and explicit follow-up.
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