In a randomized, double-blind, placebo-controlled study in 77 patients with diabetic nephropathy, patients that received low-dose pirfenidone had significantly improved eGFR and decreased markers of fibrosis (TNF, soluble TNF receptor 1, and fibroblast growth factor-23) when compared to placebo whereas no difference was noted in the high-dose group or in albuminuria [140]. The gene discussed is TNF; the disease is diabetic kidney disease.