TNF and diabetic kidney disease: As a pleiotropic cytokine, TNF-α exerts multiple effects and it can contribute to the development of diabetic nephropathy through several mechanisms, including reduction of the glomerular blood flow and glomerular filtration rate, vasoconstriction induced by increased endothelin-1 production, and disruption of the glomerular filtration barrier which is mediated by the interaction with the intercellular junctions and leads to proteinuria [14].