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Background: Peritoneal fibrosis is a major intractable complication of long-term peritoneal dialysis, and would eventually lead to peritoneal ultrafiltration failure and the termination of peritoneal dialysis. Hypoxia-inducible factor 1-alpha (HIF1A) has been reported to regulate vascular endothelial growth factor (VEGF) and involves in peritoneal fibrosis, but the exact molecular regulation mechanism remains unknown., Methods: HIF1A and VEGF protein levels were measured in 42 peritoneal patients using enzyme linked immunosorbent assay. Bioinformatics, reverse transcription-polymerase chain reaction, correlation analysis, RNA interference, gene over-expression and luciferase assays were performed to clarify the competing endogenous RNA (ceRNA) regulation between HIF1A and VEGF., Results: Both HIF1A and VEGF levels were elevated in the peritoneal effluent of peritoneal dialysis patients with ultrafiltration problems, and were positively correlated with each other at protein level and mRNA level. Bioinformatics analysis identified 8 common targeted miRNAs for HIF1A and VEGF, including miR-17-5p, 20a, 20b, 93, 106a, 106b, 199a-5p and 203. MiR-17-5p was proved to be present in patients' peritoneal effluent and selected for further studies. HIF1A mRNA and VEGF mRNA could regulate each other, and miR-17-5p was required in the regulations. Down/up regulation of HIF1A mRNA and VEGF mRNA resulted in up/down regulation of miR-17-5p. Furthermore, down/up regulation of miR-17-5p was associated with up/down regulation of HIF1A mRNA and VEGF mRNA. Luciferase assay indicated that HIF1A and VEGF regulated each other through 3'UTR., Conclusion: HIF1A and VEGF could regulate each other in peritoneal mesothelial cell in the mediation of miR-17-5p and 3'UTR, indicating HIF1A and VEGF might regulate each other through competing endogenous RNA mechanism in the development of peritoneal fibrosis., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

Aim To investigate the changing of idiopathic membranous nephropathy ( iMN) in China. Methods This study retrospectively analyzed renal disease spectrum of 6049 patients who underwent renal biopsy at Peking University First Hospital from January 2003 to December 2012. The patients were grouped into two periods at a 5-year interval: 2003-2007 (period 1) and 2008-2012 (period 2). Results Among 6049 renal biopsied patients, 3831 (63.3%) patients were diagnosed as primary glomerular disease ( PGD). The proportion of nephrotic syndrome ( NS) in PGD was significantly higher in period 2 than that in period 1 (1016/2214 [55.0%] vs 682/1617 [42.2%], P = 0.022). The proportion of iMN in PGD increased from 16.8% (217/1617) in period 1 to 29.35% (646/2214) in period 2 in all groups of age ( P < 0.001). There was no significant difference of clinical characteristics including age, gender, hypertension, serum cholesterol and proteinuria between the two periods ( P > 0.05). However, in young patients with iMN (14-44 years old), the percentage of renal histopathology stage I and stage II of iMN in PGDs was significantly higher in period 2 than that in period 1 (101/1240 [8.15%] vs 210/1340 [15.7%], P < 0.001). Conclusion Our study suggests that the frequency of iMN in PGD in our referral diagnostic centre has doubled over the past 10 years. The increase of adult iMN is mainly due to the increase of early stages of iMN in young patients. [ABSTRACT FROM AUTHOR]