Role of transforming growth factor beta (TGFB) in peritoneal membrane injury. TGFB has multiple actions directly on elaboration of extracellular matrix (ECM), upregulation of various growth factors and metalloproteinases (MMPs), and induction of epithelial mesenchymal transition (EMT). TGFB also induces blood vessel growth directly through vascular endothelial growth factor (VEGF) and secondarily through hypoxia driven mechanisms.