TNF and chronic kidney disease: And finally, it has been repeatedly shown that advanced CKD is associated with a state of chronic inflammation, as evidenced by either elevated levels of various proinflammatory cytokines (IL-1β, IL-6, TNF-α, etc.)or altered levels of acute-phase proteins (CRP, albumin, fetuin-A, etc.), which in turn are associated with increased rate of CKD progression and risk of death [30, 31].