TNFRSF1A and diabetic kidney disease: Furthermore, another study comprising patients with type 2 diabetes, including advanced DKD (stage 3 CKD and/or macroalbuminuria), showed that patients with TNFR1 levels in the highest quartile had a nearly 80% cumulative incidence of progressing to ESRD after 12 years of follow-up, whereas those with TNFR1 levels in the lowest three quartiles had <20% cumulative incidence.