Transcription factor 21 (TCF21) is one of the essential transcription factors in kidney development. To elucidate its influence on glomerular disease, we have investigated TCF21 expression in human and rat kidney tissue, and its urinary concentration. Immunohistological analysis suggested the highest TCF21 expression in nephrotic syndrome along with the urinary protein level. Urinary TCF21 concentration in human showed a positive correlation with its podocyte expression level. In nephrotic rat models, TCF21 expression in podocytes increased along with the severity of nephrotic syndrome. Next, in vitro experiments using Tcf21-expressing murine podocyte cell line, we could observe some Tcf21dependent effects, related with actin cytoskeleton dysregulation and apoptosis. Our study illustrated TCF21 expression changes in vivo and its in vitro-functional significance injured podocytes. Kidney development requires the contribution and coordination of multiple master genes. Among them, several transcription factors, which are responsible for both podocyte differentiation and morphogenesis, contribute to the development of proteinuria due to podocyte dysregulation. As we mention below, Wilms tumor suppressor gene (Wt1) and V-maf musculoaponeurotic fibrosarcoma oncogene homolog B (Mafb) are examples of such factors that regulate podocyte development 1,2. As a first example, Wt1 expressed in the metanephric mesenchyme of mammals is identified as a key transcription factor in developing metanephros 3. In humans, WT1 abnormality has been reported to cause Denys-Drash syndrome (DDS), which presents with genetic steroid resistant nephrotic syndrome 1. In addition, adult Wt1 conditional knockout mice developed a glomerular injury resembling human DDS 4. A second example, the Mafb gene, also known as Kreisler/Krml1, is expressed in podocytes in the latter stage of metanephric development and participates in the formation of the foot process 2,5. Adult Mafb knockout mice exhibit diffuse foot processes effacements with nephrin deficiency and may ultimately develop congenital nephrotic syndrome. Moreover, adult Mafb overexpression mice protect podocytes in diabetic kidney disease model 6. Recently in humans, MAFB mutation was reported to develop Duane Retraction syndrome with focal segmental glomerulosclerosis (FSGS) 7. In addition to Wt1 and Mafb, here we present transcription factor 21 (Tcf21, also called Pod1/Capsulin/Epicardin), belonging to the basic-helix loop helix (bHLH) family, as a key factor in kidney development 8. Tcf21 is expressed in the mesenchyme of multiple organs such as the kidney, heart and lung and plays an essential role in organ morphogenesis 9. During metanephrogenesis, Tcf21 first appears on E10.5 mouse mesenchymal cells, and is then expressed in nephron progenitor cells in the later stage, such as s-shaped body stage 8,10. During late nephrogenesis, its expression is limited to interstitial cells and podocytes differentiated from nephron progenitor cells. A lack of Tcf21 results in hypoplastic metanephros,...