There are also very high rates of other risk factors such as autoimmune disease [10], prostate disease [11], presence of the APOL-1 gene [12], and low birth weights [13], but published data on their prevalence rates are lacking. This study highlights hypertension, diabetes, and obstructive uropathy being the leading causes of ESRD in Trinidad and Tobago. Over the two-year period, 177 (66.8%) of patients had either diabetes, hypertension, or both, as the cause for ESRD, suggesting deficiencies in primary care management. Here, APOL1 is linked to urinary tract obstruction.