Slight acceleration in podocyte mRNA loss in preterm-born children aged 3-5 years

Introduction 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 microalbumin 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 microalbumin 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.