A 2017 review by Mansour et al. on renal fibrosis biomarkers not related to Leptospira identified that urine transforming growth factor-beta (TGF-β), blood and urine matrix metalloproteinase-2 (MMP-2), and MCP-1 were associated with adverse renal outcomes based on a longitudinal follow-up of patients.32 This evidence concerns the gene MMP2 and renal fibrosis.