Clinical Report: Serum GDF15 in School-Age Children Born Preterm

Overview

In this study of 123 school-age children, serum GDF15 concentrations were higher in both preterm-born groups than in term-born children, with no significant difference between preterm children with reduced versus normal renal function. GDF15 was inversely correlated with eGFRcr within the reduced-function group, but this association was no longer statistically significant after exclusion of the participant with the lowest eGFRcr; no significant correlation was observed across all participants.

Background

Preterm birth is associated with increased risk of chronic kidney disease, particularly during childhood, but the mechanisms of renal dysfunction and biomarkers of long-term renal prognosis remain insufficiently characterized. GDF15 is a stress-responsive cytokine induced by cellular stressors including inflammation and mitochondrial dysfunction, and circulating concentrations rise with age. Prior evidence cited by the study links higher GDF15 with CKD progression in children. The study assessed whether serum GDF15 concentrations were associated with renal function in school-age children born preterm.

Data Highlights

Key Findings

• The study included 17 term-born children, 23 preterm-born children with reduced renal function, and 83 preterm-born children with normal renal function.
• Gestational age and birth weight differed significantly among groups; BMI SDS and blood pressure did not.
• Serum GDF15 was significantly higher in both preterm groups than in the term-born group, while PR and PN concentrations did not differ significantly.
• eGFRcr was lowest in the PR group and comparable between the PN and T groups.
• Across all participants, GDF15 was not significantly correlated with eGFRcr (ρ=−0.15, p=0.10); within PR, the inverse correlation was ρ=−0.43 (p=0.04).
• After excluding the PR participant with the lowest eGFRcr, the inverse association was not statistically significant (ρ=−0.38, p=0.084); no significant association was found in PN (ρ=−0.05, p=0.63).

Clinical Implications

The study reports higher serum GDF15 in preterm-born children regardless of whether eGFRcr was below or above 90 mL/min/1.73 m², and it does not establish GDF15 as a predictor of renal prognosis. The authors note that elevated GDF15 in the PN group suggests reduced renal function alone may not account for the elevation in preterm-born children.

Conclusion

Serum GDF15 concentrations were higher in school-age children born preterm than in term-born controls, without a significant difference by renal-function subgroup. The inverse association with eGFRcr in the reduced-function subgroup was not statistically significant in sensitivity analysis.

Related Resources & Content

1. Study authors, source and year not provided -- Serum Growth Differentiation Factor 15 Concentrations in School-Age Children Born Preterm
2. Kidney care at NICU discharge and follow-up recommendations for preterm infants <34 weeks, PMC, 2026 -- Kidney care at NICU discharge and follow-up recommendations for preterm infants <34 weeks
3. Systematic review authors and year not provided, PubMed -- Circulating Growth Differentiation Factor 15 (GDF15) in Paediatric Disease: A Systematic Review
4. The Journal of Clinical Endocrinology & Metabolism — Growth Patterns in Preterm and Low Birth Weight Full-Term Children from Birth to Preschool: A National Analysis
5. The Journal of Clinical Endocrinology & Metabolism — Bioactive IGF-I Levels in Pediatric Patients Undergoing Growth Hormone Treatment
6. Frontiers in Pediatrics — Determinants of growth parameters at 12-month corrected age among very preterm infants in China: a retrospective cohort study
7. MDSpire News — Placental Growth Factor Test Predicts Preterm Birth
8. Kidney care at NICU discharge and follow-up recommendations for preterm infants <34 weeks
9. Circulating Growth Differentiation Factor 15 (GDF15) in Paediatric Disease: A Systematic Review
10. Circulating Growth Differentiation Factor 15 (GDF15) in Paediatric Disease: A Systematic Review.
11. CKD Evaluation and Management – KDIGO