TNF and Insulin resistance: Deleterious effects of intraglomerular hypertension and glomerular hyperthrophy, increased secretion of transforming growth factor beta (TGF-β) leading to glomerulosclerosis, hormonal changes, such as hyperaldosteronism and related pro-inflammatory cytokine secretion, including interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α), coexisting lipid disorders and insulin resistance have all been implicated in obesity-driven CKD [21].