Background: Low birth weight is associated with deficits in nephron number in the infant kidney and increased risk of adulthood hypertension and renal dysfunction. Urinary biomarkers may be potential indicators of renal reserve, but little is known about the influence of gestational and postnatal age on the expression of urinary proteins. The aims of this study were to determine the relationships between selected urinary proteins and renal maturation. We hypothesized that urinary protein patterns would change over time during late nephrogenesis and renal maturation. Methods: Urine samples were collected at birth and over 12 mo from preterm (33-35 wk) and term (38-40 wk) infants. candidate urinary proteins were identified by antibody array and quantified with enzyme-linked immunosorbent assay. results: Preterm infants at birth were found to have relatively elevated levels of insulin-like growth factor binding protein-1, -2, and -6, monocyte chemotactic protein-1, cD14, and sialic acid-binding Ig-like lectin 5. These markers gradually decline to levels similar to those of full-term infants by 2-6 mo of life. In contrast, many urinary markers in healthy full-term infants remain stable over the first year of life. conclusion: Gestational and postnatal age must be considered when evaluating the utility of urinary biomarkers. P remature infants are challenged to adapt to an ex utero environment while organogenesis remains incomplete. In humans, ~60% of nephrons develop during the third trimester (1) with nephrogenesis complete at 32-36 wk gestation (2). Although the kidney continues to mature for an additional 1-2 y, full-term infants have a complete endowment of nephrons, varying widely from 250,000 to 1.8 million per kidney, by 36 wk gestation (2,3) and do not form new nephrons after birth. However, the duration of nephrogenesis and the health of the nephrons in infants born prematurely remain unknown. There appears to be a correlation between gestational age and nephron number in large animal species. Studies in baboons demonstrate a direct correlation between gestational age and nephron number (4). Moreover, prematurely delivered baboons continue to develop nephrons after birth, but the length of gestation inversely correlates with the number of abnormal nephrons (4) (the lower the gestational age the higher the number of abnormal nephrons). There may be a limited window for nephrogenesis to continue postnatally in humans. A single autopsy study has shown that nephrogenesis appears to continue for 40 postnatal days in extremely preterm human infants and then cease (5). A smaller complement of nephrons may not be reflected by renal dysfunction in the preterm infant. However, adults born at a low birth weight, with a reduced number of nephrons, are at increased risk of hypertension, impaired kidney function, and cardiovascular disease (6).As the overall mortality of the premature population decreases, the risk of long-term morbidity in this population emerges (7). Barker and Martyn (8) established a framework for th...