Serum Transforming Growth Factor-Beta 1 and Creatinine for Early Diagnosis of CKD of Unknown or Uncertain Etiology Phenotypes

The global burden of kidney diseases has disproportionally increased over the last 2 decades.1 Although diabetes and hypertension are leading causes of chronic kidney disease (CKD), environmental risk factors contribute to a significant disease burden in hot spots of Mesoamerican countries, such as India, and Sri Lanka.2,3 CKD associated with environmental risk factors, CKD of uncertain or unknown etiology (CKDu), is prevalent among farming communities living in these at-risk areas. Recently, a subcategory of patients has been reported from these at-risk areas for CKDu in Nicaragua and Sri Lanka.