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Circular RNAs (circRNAs) have been extensively studied in various diseases, including sepsis-induced acute kidney injury (AKI). This research intended to elucidate the mechanism of circular RNA HIPK3 (circHIPK3) in sepsis-engendered AKI. Human tubule epithelial cells (HK2) were stimulated with lipopolysaccharide (LPS) to establish a septic AKI cell model. The gene expression levels were evaluated by RT-qPCR. Cell viability, apoptosis, and cell cycle distribution were assessed through CCK-8 and flow cytometry assays. The potential interactions between genes were verified by luciferase reporter and RIP assays. The results displayed that circHIPK3 expression was enhanced in septic AKI patients and LPS-triggered HK2 cells. Moreover, circHIPK3 interference expedited HK2 cell viability and attenuated apoptosis, inflammatory and oxidative damages following LPS stimulation. Furthermore, circHIPK3 functioned as a molecular sponge for miR-338, and forkhead box A1 (FOXA1) was negatively regulated by miR-338. CircHIPK3 aggravated cell injury in LPS-treated HK2 via targeting miR-338, and FOXA1 addition overturned the suppressing impacts of miR-338-3p augmentation on LPS-activated HK2 cell damage. Finally, we demonstrated that circHIPK3 modulated LPS-induced cell damage via the miR-338/FOXA1 axis. In sum, our results elaborated that circHIPK3 knockdown attenuated LPS-triggered HK2 cell injury by regulating FOXA1 expression via interacting with miR-338, suggesting that circHIPK3 might be a potential biomarker and therapeutic target for sepsis-induced AKI patients.

Background and Aims The volume factor of maintenance hemodialysis patients is closely related to the prognosis. We hypothesized that the excess weight after dialysis (end-dialysis over-weight, edOW) is an important factor of volume impact survival in hemodialysis (HD) patients. The purpose of this study was to analyze the relationship between edOW and long-term prognosis of patients with maintenance hemodialysis. Method This retrospective study observed incident hemodialysis patients who treated in Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017, three times a week for at least one year. The end point of follow-up was death, abdominal dialysis, kidney transplantation, transfer or until April 30, 2018. The general data of the patients included age, gender, BMI, primary renal disease, CVD, first hemodialysis access, albumin(Alb), Haemoglobin(Hb), blood pressure, heart rate, ultrafiltration rate(UFR), interdialytic weight gain IDWG, end -dialysis overweight (edOW). Cox multivariate regression was used to analyze the relationship between edow and all-cause mortality and cardiovascular mortality. Results Totally 469 patients male, 64% were enrolled, with an average age of 56.9 ± 17.1 years. During the follow-up period, 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.7%. The mean value of edow was 0.28 ± 0.02 kg. Kaplan-Meier(Log-rank test) survival analysis showed that the long-term survival rate of the group with edow ≤ 0.28kg was better than that of the group with edow > 0.28kg (P = 0.042), and the cardiovascular mortality of the group with edow > 0.28kg was significantly higher than that of the group with edow ≤ 0.28kg (P = 0.001). Cox multivariate regression analysis showed that edow was an independent risk factor for all-cause death in hemodialysis patients (P = 0.025, AhR = 1.541, 95% CI 1.057-2.249), and also an independent risk factor for CVD death in hemodialysis patients (P = 0.007, AhR = 1.929, 95% CI 1.198-3.107). Conclusion EdOW is an independent risk factor of long-term all-cause and cardiovascular death in hemodialysis patients.

Background and Aims To investigate the efficacy of parathyroidectomy (PTX) in the treatment of persistent hyperparathyroidism (PHPT) after renal transplantation and the effect of PTX on renal allograft function. Method This single-center retrospective study enrolled 31 patients who underwent PTX for the treatment of PHPT after renal transplantation in the Kidney Disease Center of the First Affiliated Hospital of Zhejiang University from May 2010 to Oct. 2018. The changes of serum calcium, serum phosphorus, alkaline phosphatase, parathyroid hormone(PTH), serum creatinine, and estimated glomerular filtration rate (eGFR) in the preoperative and postoperative periods (1w, 1m, 3m, 6m,12m) were compared. The operative successful rate (12 m) and postoperative complications were calculated. Results The serum calcium before PTX was (2.78±0.18) mmol/L, which decreased significantly to (2.19±0.34) mmol/L at 1 week postoperatively (P Conclusion PTX can quickly and effectively alleviate high calcium, low phosphorus, high PTH and high alkaline phosphatase after renal transplantation. PTX is effective and safe in the treatment of PHPT after renal transplantation, and has no effect on renal allograft function.