Step 1: Understanding the question.
The question asks for the primary etiology of CKD globally, driven by metabolic factors.
Step 2: Analyzing the options.
(A) Hypertension: Major contributor but second to diabetes.
(B) Glomerulonephritis: More prevalent in some regions but not globally leading.
(C) Diabetes mellitus: Correct — High fasting glucose is the top risk factor per GBD studies.
(D) Obstructive nephropathy: Less common globally.
Step 3: Conclusion.
The correct answer is (C) Diabetes mellitus, the leading cause of chronic kidney disease worldwide.