This process that typically occurs in the early stages of diabetic kidney disease is characterized by decreased local production of nitric oxide and enhanced production of reactive oxygen species, proinflammatory and cell adhesive molecules including tumor necrosis factor-α (TNF-α), plasminogen activator inhibitor-1 (PAI-1), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and others [13]. Here, TNF is linked to diabetic kidney disease.