Clinical Scorecard: Serum Growth Differentiation Factor 15 Concentrations in School-Age Children Born Preterm
At a Glance
Category
Detail
Condition
Serum GDF15 concentrations and renal function in school-age children born preterm
Key Mechanisms
GDF15 is a cytokine induced by cellular stress, including mitochondrial dysfunction and inflammation; circulating concentrations rise with age.
Target Population
Nine-year-old children born preterm, compared with term-born children.
Care Setting
Observational, single-center study involving a 9-year health checkup and additional renal evaluation at Yamanashi University Hospital for children with eGFRcr below 90 mL/min/1.73 m².
Key Highlights
The study included 23 preterm-born children with reduced renal function, 83 preterm-born children with normal renal function, and 17 term-born children.
Serum GDF15 concentrations were significantly higher in both preterm groups than in term-born children; the two preterm groups did not differ significantly.
Across all participants, GDF15 was not significantly correlated with eGFRcr (ρ = −0.15, p = 0.10).
Within the reduced-renal-function group, GDF15 was inversely correlated with eGFRcr (ρ = −0.43, p = 0.04), but this association was not statistically significant after excluding the participant with the lowest eGFRcr.
The clinical relevance of elevated GDF15 remains uncertain; the authors call for larger longitudinal studies.
Guideline-Based Recommendations
Diagnosis
Preterm-born children were classified by eGFRcr: reduced renal function was defined as below 90 mL/min/1.73 m² and normal renal function as 90 mL/min/1.73 m² or higher.
eGFRcr was calculated using an equation developed specifically for Japanese children.
Management
Monitoring & Follow-up
Risks
Preterm birth is associated with increased CKD risk across the lifespan, with the association especially pronounced in childhood.
The study did not establish whether GDF15 predicts long-term renal outcomes or explain the mechanisms underlying its elevation.
Patient & Prescribing Data
Children attending a 9-year-old health checkup after preterm birth; term-born children visiting Yamanashi University Hospital served as comparators. Children with specified kidney, acute illness, metabolic, cardiac, syndromic, or medication-related exclusions were not enrolled.
No treatment was evaluated or recommended. Serum GDF15 was measured using a commercial ELISA kit; its clinical relevance in this population remains uncertain.
Clinical Best Practices
Interpret the GDF15–eGFRcr association in the reduced-renal-function group cautiously: it was no longer statistically significant in the sensitivity analysis excluding the participant with the lowest eGFRcr.
Do not infer that elevated GDF15 is specific to renal dysfunction: concentrations were also higher in preterm-born children with normal renal function than in term-born children.
The authors state that larger longitudinal investigations are needed to assess whether GDF15 is associated with later renal outcomes.
