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Slight acceleration in podocyte mRNA loss in preterm-born children aged 3-5 years
Zhengqi Cui1,2, Chao Ning1,3,4, Junling Ma1,3,4
1Department of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin, China.
Insights
Preterm children show significantly higher podocyte mRNA loss by age 3-5, indicating a risk for chronic kidney disease (CKD). Gestational age and antenatal corticosteroid use are key factors in this podocyte depletion.
Area of Science:
- Pediatric Nephrology
- Neonatology
- Developmental Biology
Background:
- Global survival rates for preterm infants are rising, but long-term health outcomes, particularly kidney function, remain a concern.
- Podocyte depletion is a suspected contributor to chronic kidney disease (CKD) in preterm infants.
- Investigating podocyte health in early childhood is crucial for understanding preterm infant prognosis.
Purpose of the Study:
- To quantify podocyte mRNA loss in 3-5-year-old children born preterm versus full-term.
- To explore the association between podocyte depletion and the risk of CKD in preterm infants.
- To identify perinatal factors influencing podocyte loss.
Main Methods:
- Urine samples from 80 children (42 preterm, 38 full-term) aged 3-5 years were analyzed.
- Podocyte mRNA levels were measured using the urinary podocin mRNA-to-creatinine ratio (UpodCR).
- Urine protein, albumin, and perinatal factors were assessed for their impact on UpodCR.
Main Results:
- Preterm children exhibited a 1.54-fold higher rate of podocyte mRNA loss compared to full-term children.
- No significant differences in urine protein or albumin levels were found between the groups.
- Lower gestational age and antenatal corticosteroid use were identified as significant risk factors for childhood podocyte loss.
Conclusions:
- This study provides the first evidence of accelerated podocyte loss in preterm children aged 3-5 years.
- Elevated podocyte loss in preterm children supports its role in the pathogenesis of preterm-related CKD.
- Findings highlight the need for careful consideration of antenatal corticosteroid use risks and benefits.
Background:
The global survival rate of preterm infants has been progressively increasing. However, concerns regarding their long-term prognosis persist. This study aimed to investigate podocyte mRNA loss in 3-5-year-old full-term and preterm children to elucidate the role of podocyte depletion in the pathogenesis of chronic kidney disease (CKD) in preterm infants.
Methods:
A total of 80 children aged 3-5 years, born at Tianjin Central Hospital of Gynecology and Obstetrics, were included in this study: 42 preterm infants (gestational age 24-29 weeks) and 38 full-term infants. Morning urine samples were collected to examine podocyte mRNA levels (expressed as the urinary podocin mRNA-to-creatinine ratio, UpodCR), urine protein, and urine albumin levels. The impact of perinatal factors on UpodCR was also analyzed.
Results:
Results indicated that the rate of podocyte mRNA loss in the preterm group was significantly higher than in the full-term group (1.54-fold). No significant differences were observed in urine protein and urine albumin levels between the two groups. Perinatal factor analysis revealed that gestational age and antenatal corticosteroid use were significant risk factors for podocyte loss in childhood.
Conclusions:
This study is the first to confirm accelerated podocyte loss in the urine of 3-5-year-old preterm children. Although less severe than in the early postnatal period, it remains higher than in full-term children, providing crucial evidence for the involvement of podocyte depletion in the pathogenesis of preterm-related CKD. It also underscores the need for careful evaluation of the benefits and risks associated with antenatal corticosteroid use.
